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Contact Information

PHYSICIAN HOME CARE OF UTAH,L.C.
6886 HOLLOW MILL DR
SALT LAKE CITY, UT84121-3322
 Phone: 801-944-0095
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for PHYSICIAN HOME CARE OF UTAH,L.C.

NPI Number 1326148073
LBN Legal business name PHYSICIAN HOME CARE OF UTAH,L.C.
Authorized official JOHN DIETLEIN - (MEDICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/23/2006
Last updated 10/19/2007 - About 19 years ago
Identifiers
UT License # 169963-1205
UT Medicaid 530429522033
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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