1669746525 NPI number — RED ROCK HEALTHCARE, INC.

Table of content: (NPI 1669746525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669746525 NPI number — RED ROCK HEALTHCARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RED ROCK HEALTHCARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ZION'S WAY HOSPICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669746525
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1173 S 250 W STE 401
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST GEORGE
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84770-7086
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-688-0648
Provider Business Mailing Address Fax Number:
435-688-0715

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1173 S 250 W STE 401
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST GEORGE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84770-7086
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-688-0648
Provider Business Practice Location Address Fax Number:
435-688-0715
Provider Enumeration Date:
02/23/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
LEE
Authorized Official Middle Name:
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
208-401-1369

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  2010-HOSPICE-72725 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251G00000X , with the licence number: HSPC4777 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)