Provider Demographics
NPI:1285404293
Name:SANDALL CARE CORP
Entity type:Organization
Organization Name:SANDALL CARE CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-739-4907
Mailing Address - Street 1:460 N UNIVERSITY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-2893
Mailing Address - Country:US
Mailing Address - Phone:801-739-4907
Mailing Address - Fax:
Practice Address - Street 1:460 N UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-2893
Practice Address - Country:US
Practice Address - Phone:801-739-4907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care