MEDICARE: WASATCH HOMELESS HEALTH CARE, INC.

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
1	333600000X	Pharmacy
2	3336C0002X	Clinic Pharmacy	49490201703	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4695613	OTHER		OTHER ID NUMBER

General Provider Information

NPI Number	:	1720270275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASATCH HOMELESS HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	409 W 400 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84101-1135
Country	:	US
Telephone Number	:	801-333-8628
Fax Number	:	801-433-0153

Provider Business Practice Location Address
First Line	:	409 WEST 400 SOUTH
Second Line	:
City	:	SALT LAKE
State	:	UT
Zip	:	84101-8410
Country	:	US
Telephone Number	:	801-333-8628
Fax Number	:	801-433-0153

Authorized Official
Title or Position	:	CEO
Name	:	JANIDA EMERSON
Credential	:
Telephone Number	:	801-364-0058

Provider Enumeration Date	:	08/17/2007
Last Update Date	:	12/02/2025

Similar Medicare Providers

1265915300 — ANTONIO RIVAS
Practice Location Address:

3160 CROW CANYON PL. #205
SAN RAMON, UT
84101-8410

Practice Phone: 818-241-6780
Practice Fax:

1619292182 — DR. RICHARD KELLER M.D.
Practice Location Address:

1235 EAST 200 SOUTH #702 , 1235 EAST 200 SOUTH #702
SALT LAKE CITY, UT
84102-8410

Practice Phone: 801-355-9040
Practice Fax:

1053820167 — RACHAEL BOHLING
Practice Location Address:

439 E 900 S
SALT LAKE CITY, CA
84109-8410

Practice Phone: 801-203-0558
Practice Fax:

1043929524 — MR. PADEN SPENCE CARTER MA
Practice Location Address:

434 S 500 E
SALT LAKE CITY, UT
84102-8410

Practice Phone: 801-359-8862
Practice Fax:

1972616464 — DR. LENORE MILLIAN PH.D.
Practice Location Address:

200 TICE BLVD
WOODCLIFF LAKE, NJ
07677-8410

Practice Phone: 201-934-7788
Practice Fax:

1467517664 — MRS. LAURIE LEE KELLY RDH
Practice Location Address:

4550 DOGWOOD DR
LAKE OSWEGO, OR
97035-8410

Practice Phone: 503-310-9485
Practice Fax: 503-620-1635

Directions to “WASATCH HOMELESS HEALTH CARE, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.