1447682034 NPI number — RELIANCE HOSPICE OF UTAH

Table of content: (NPI 1447682034)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447682034 NPI number — RELIANCE HOSPICE OF UTAH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RELIANCE HOSPICE OF UTAH
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:
RELIANCE 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:
1447682034
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
840 W 1700 S
Provider Second Line Business Mailing Address:
SUITE 13
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84104-1703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-590-8900
Provider Business Mailing Address Fax Number:
801-590-8917

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
840 W 1700 S
Provider Second Line Business Practice Location Address:
SUITE 13
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84104-1703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-590-8900
Provider Business Practice Location Address Fax Number:
801-590-8917
Provider Enumeration Date:
08/06/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BIDDULPH
Authorized Official First Name:
BECKI
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
801-590-8900

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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