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NPI Code Detail

MEDICARE: MOAB VALLEY HEALTHCARE, INC

MEDICARE: MOAB VALLEY HEALTHCARE, 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
1251G00000XCommunity Based Hospice Care Agency2006-HOSPICE-926UT
2282NC2000XChildren's HospitalUT
3282NC0060XCritical Access Hospital2005-HOSP-45117UT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1461518OTHERUTHOSPICE MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770513236
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOAB VALLEY HEALTHCARE, INC
Provider Business Mailing Address
First Line : 450 W WILLIAMS WAY
Second Line : P.O.BOX 998
City : MOAB
State : UT
Zip : 84532-0998
Country : US
Telephone Number : 435-719-3501
Fax Number : 435-719-3509
Provider Business Practice Location Address
First Line : 450 W WILLIAMS WAY
Second Line :
City : MOAB
State : UT
Zip : 84532-2065
Country : US
Telephone Number : 435-719-3501
Fax Number : 435-719-3509
Authorized Official
Title or Position : CEO
Name : MS. JENNIFER SADOFF
Credential :
Telephone Number : 435-719-3514
Provider Enumeration Date : 07/03/2006
Last Update Date : 12/12/2018

Similar Medicare Providers

1023091931 — KENNETH LEWIS WILLIAMS M.D.
Practice Location Address:
476 WILLIAMS WAY , STE A
MOAB, UT
84532-2065
Practice Phone: 435-259-7121
Practice Fax: 435-259-3112
1669455580 — KATHERINE KALLMEYER WILLIAMS M.D.
Practice Location Address:
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1801879721 — JONAS SETH MUNGER M.D.
Practice Location Address:
476 WILLIAMS WAY , STE A
MOAB, UT
84532-2065
Practice Phone: 435-259-7121
Practice Fax: 435-259-3112
1780638973 — MELINDA J STANFORD FNP
Practice Location Address:
476 WILLIAMS WAY
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84532-2065
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1528070489 — MOAB FAMILY MEDICINE PC
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1902917438 — NICOLE LEE PRIEST M.D.
Practice Location Address:
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84532-2065
Practice Phone: 435-259-7121
Practice Fax: 435-259-3112

Directions to “MOAB VALLEY HEALTHCARE, INC ” Practice Location

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