East Lake Care Center, Llc in Provo - Parenteral & Enteral Nutrition
East Lake Care Center, Llc - NPI 1326093261
East Lake Care Center, Llc is a Parenteral & Enteral Nutrition in Provo, Utah. East Lake Care Center, Llc practices all healthcare services and medical treatments related to Parenteral & Enteral Nutrition. The NPI Number for East Lake Care Center, Llc is 1326093261. The last update date is 2008-01-03.
East Lake Care Center, Llc's current location address is 101 N 500 W, Provo, Utah. You can contact this provider via phone number 8013779661 and fax number 8013779747. The mailing address for East Lake Care Center, Llc is 101 N 500 W, Provo, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | East Lake Care Center, Llc |
|---|---|
| Address | 101 N 500 W, Provo, Utah |
| Phone Number | 8013779661 |
| Fax Number | 8013779747 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEMBER |
|---|---|
| Authorized Official Name | Johnson R Craig |
| Telephone Number | 8012681122 |
NPI Number Detail
| NPI Number | 1326093261 |
|---|---|
| Provider Enumeration Date | 2006-05-22 |
| Last Updated Date | 2008-01-03 |
Provider Mailing Address Detail
| Address | 101 N 500 W |
|---|---|
| City | Provo |
| State | Utah (UT) |
| Post Code | 846012646 |
| Phone Number | 8013779661 |
| Fax Number | 8013779747 |
Provider's Primary Taxonomy Detail
| Speciality | Parenteral & Enteral Nutrition |
|---|---|
| Taxonomy | 332Bp3500X |
| Licence No | 2007-NCF-292 |
|
Definition: Durable medical equipment and supplies for tube feeding and intravenous nutritional support prescribed by providers. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 870439756011 | UT | -- |
Post Comment/ Review Below
What is the unique identifier code issued to East Lake Care Center, Llc by the Centers for Medicare & Medicaid Services?
The East Lake Care Center, Llc has been assigned the NPI (National Provider Identifier) 1326093261. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where East Lake Care Center, Llc's facilities are geographically located?
The facilities of East Lake Care Center, Llc are physically situated at the following location: 101 N 500 W, Provo, UT, 846012646.
What is the East Lake Care Center, Llc's specialty and taxonomy code?
The East Lake Care Center, Llc's specialty is Parenteral & Enteral Nutrition, and the corresponding taxonomy code is 332Bp3500X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1326093261 to East Lake Care Center, Llc?
The Centers for Medicare & Medicaid Services originally issued the 1326093261 to East Lake Care Center, Llc on 2006-05-22.
As of what date was the information regarding East Lake Care Center, Llc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to East Lake Care Center, Llc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2008-01-03.