Caresource
Organization Active NPI Home Health Agency · Park City, UT
NPI 1902861693 · NPPES record last updated Nov 14, 2016
Key facts
- NPI
- 1902861693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 2006-HHA-912 (UT)
- Legal business name
- CARESOURCE
- Practice address
- 750 Kearns Blvd. #200
Park City, UT 84060 - Phone
- (801) 266-7200
- Fax
- (801) 266-7004
- NPI assigned
- Apr 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Shawntel Elizabeth Tanner, MA
- Title
- Ceo/Administrator
- Phone
- (801) 266-7200
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Caresource
Locations
750 Kearns Blvd
#200
Park City, UT 84060
Phone (801) 266-7200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 2006-HHA-912 | UT | Yes |
Addresses
Primary practice location
750 Kearns Blvd. #200
Park City, UT 84060
Mailing address
PO Box 680839
750 Kearns Blvd. #200
Park City, UT 84068
Phone (801) 266-7200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HT005376-001 | Other | UT | TRADING PARTNER NUMBER |
Other names
- CareSource Home Health and Hospice
Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.