National Provider Identifier Database

CARESOURCE CHARITABLE ASSOCIATION
Hospice Care, Community Based


Contact Information

CARESOURCE CHARITABLE ASSOCIATION
750 KEARNS BLVD # 200
PARK CITY, UT84060-5137
Phone: 801-266-7200
Fax: 801-266-7004
Website:
Specialty Taxonomy Code
* Hospice Care, Community Based 251G00000X

* Indicates primary specialty

NPI Profile & details for CARESOURCE CHARITABLE ASSOCIATION

NPI Number 1932656923
Legal business name
LBN
CARESOURCE CHARITABLE ASSOCIATION
Authorized official SHAWNTEL TANNER - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 09/07/2016
Last updated 11/14/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • UT License #: 2016

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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