Squire Boys, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2012-HOSPICE-92677 Issued in UT

Legal business name

SQUIRE BOYS, INC.

Practice address

415 Medical Dr Ste C102
Bountiful, UT 84010-8902

Phone

(801) 335-0522

Fax

(801) 335-0523

NPI assigned

Aug 8, 2013

Organization subpart

No

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

Authorized official

Name

Derek Squire

Title

Administrator

Phone

(801) 602-1802

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1427480714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE C102",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108902",
            "telephone_number": "801-335-0522",
            "fax_number": "801-335-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE C102",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108902",
            "telephone_number": "801-335-0522",
            "fax_number": "801-335-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUIRE BOYS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "SQUIRE",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-602-1802"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "UT",
            "license": "2012-HOSPICE-92677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott E Southworth, MD
• Parker Sovic
• Mandi Spens, PMHNP-BC
• Sports Medicine Specialists, LLC
• Sportsmed Physical Therapy of Bountiful a Professional Corp
• Janet Ruth Squire
• Reyna St Germain, DNP, FNP-BC
• Lucretia Stallings
• Standard Optical Co
• Jeremy Joseph Stanger, PHARM.D.

• Community Based Hospice Care Agency in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Community Based Hospice Care Agency in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.