1154575595 NPI number — ACCESS HOME CARE OF SLC, LLC

Table of content: JULIE ANNE MYERS PTA (NPI 1356657449)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154575595 NPI number — ACCESS HOME CARE OF SLC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCESS HOME CARE OF SLC, LLC
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:
Provider Other Organization Name Type Code:
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:
1154575595
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
74 W 100 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOGAN
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84321-4506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-755-6599
Provider Business Mailing Address Fax Number:
435-755-6548

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9565 S 700 E
Provider Second Line Business Practice Location Address:
200
Provider Business Practice Location Address City Name:
SANDY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84070-3482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-495-3090
Provider Business Practice Location Address Fax Number:
801-495-3088
Provider Enumeration Date:
11/12/2008

Additional Information

Authorized Official

Authorized Official Last Name:
TARBET
Authorized Official First Name:
CATHY
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
435-881-3104

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  PENDING , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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