Provider Demographics
NPI:1104135250
Name:RENEW HOME HEALTH INC
Entity type:Organization
Organization Name:RENEW HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-753-2438
Mailing Address - Street 1:5280 S COMMERCE DR
Mailing Address - Street 2:RENEW HOME HEALTH
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7926
Mailing Address - Country:US
Mailing Address - Phone:801-364-4250
Mailing Address - Fax:801-994-1278
Practice Address - Street 1:5280 S COMMERCE DR
Practice Address - Street 2:E160
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-5982
Practice Address - Country:US
Practice Address - Phone:801-364-4250
Practice Address - Fax:801-994-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT437322Medicare UPIN