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NPI Code Detail

MEDICARE: ACCESS PRIVATE DUTY, LLC

MEDICARE: ACCESS PRIVATE DUTY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1372600000XAdult Companion2012-HHA-97078UT
2372500000XChore Provider2012-HHA-97078UT
3376J00000XHomemaker2012-HHA-97078UT
4376K00000XNurse's Aide2012-HHA-97078UT
5385H00000XRespite Care2012-HHA-97078UT
6251B00000XCase Management Agency2012-HHA -97078UT
7251E00000XHome Health Agency2012-HHA - 97078UT
8374U00000XHome Health Aide2012-HHA - 97078UT
9253Z00000XIn Home Supportive Care Agency2011-HHA-97078UT

General Provider Information

NPI Number : 1083986947
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACCESS PRIVATE DUTY, LLC
Provider Business Mailing Address
First Line : 3080 RICHMOND STREET
Second Line : SUITE 106
City : SALT LAKE CITY
State : UT
Zip : 84106
Country : US
Telephone Number : 801-467-2880
Fax Number : 801-467-2940
Provider Business Practice Location Address
First Line : 3080 RICHMOND ST APT 106
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84106-3087
Country : US
Telephone Number : 801-467-2880
Fax Number : 801-467-2940
Authorized Official
Title or Position : OWNER - DIRECTOR
Name : MR. JOHN WILLIAM SUMSION
Credential : PHR
Telephone Number : 801-319-8833
Provider Enumeration Date : 02/07/2012
Last Update Date : 12/28/2012

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Directions to “ACCESS PRIVATE DUTY, LLC ” Practice Location

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