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NPI Code Detail

MEDICARE: SAPPHIRE HEALTH & WELLNESS LLC

MEDICARE: SAPPHIRE HEALTH & WELLNESS 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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1619446119
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAPPHIRE HEALTH & WELLNESS LLC
Provider Business Mailing Address
First Line : 880 HERITAGE PARK BLVD STE 130
Second Line :
City : LAYTON
State : UT
Zip : 84041-5674
Country : US
Telephone Number : 801-335-4114
Fax Number : 833-569-5678
Provider Business Practice Location Address
First Line : 880 HERITAGE PARK BLVD STE 130
Second Line :
City : LAYTON
State : UT
Zip : 84041-5674
Country : US
Telephone Number : 801-335-4114
Fax Number : 833-569-5678
Authorized Official
Title or Position : OWNER
Name : JILLIAN LOZANOFF
Credential : NP
Telephone Number : 801-335-4114
Provider Enumeration Date : 11/14/2018
Last Update Date : 11/14/2018

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Directions to “SAPPHIRE HEALTH & WELLNESS LLC ” Practice Location

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