Provider Demographics
NPI:1316422553
Name:WASATCH HOME HEALTH, LLC
Entity type:Organization
Organization Name:WASATCH HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GEHRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-246-6540
Mailing Address - Street 1:14 DAWN HILL DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-4901
Mailing Address - Country:US
Mailing Address - Phone:425-246-6540
Mailing Address - Fax:
Practice Address - Street 1:1438 E VALLEY RIDGE DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84093-6653
Practice Address - Country:US
Practice Address - Phone:801-255-5209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health