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General NPI Number Information
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NPI Number | 1417643461
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Entity Type | Organization
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Legal Business Name | PACK.CARE
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 14287 US HIGHWAY 189
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City | BONDURANT
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State | WY
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Zip | 82922
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Country | US
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Telephone | 801-836-1349
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Fax |
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Provider Business Mailing Address
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Address Line | 14287 US HIGHWAY 189
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City | BONDURANT
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State | WY
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Zip | 82922
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF SALES
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Name | JOSEPH KELSON
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Credential |
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Telephone | 801-836-1349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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