Eagles Soar Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

V12183 Issued in UT

Legal business name

EAGLES SOAR INC.

Doing business as

Majestic Care and Rehabilitation Center

Practice address

433 E 2700 S
Salt Lake City, UT 84115-3325

Phone

(801) 487-2248

Fax

(801) 746-8669

NPI assigned

May 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Walter Matjasich

Title

Owner

Phone

(801) 487-2248

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Majestic Care and Rehabilitation Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1326098039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 E 2700 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153325",
            "telephone_number": "801-487-2248",
            "fax_number": "801-746-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 E 2700 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153325",
            "telephone_number": "801-487-2248",
            "fax_number": "801-746-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES SOAR INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "MATJASICH",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-487-2248",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "license": "V12183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870291297015",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Majestic Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Catherine Dziubyk, RD
• E Alan Jeppsen MD PC
• Chandler Eads
• Samuel Eads
• Eagle Medical LLC (Eagle Medical)
• Robert Taylor Eakins
• Ear, Nose & Throat Hearing Center, LLC
• Destenee Marie Earl Mathews
• Glenn L Earl, PH.D., O.M.D.
• Ivan D Earl, PT

• Skilled Nursing Facility in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Skilled Nursing Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.