Provider Demographics
NPI:1891750535
Name:WEST VALLEY HOME HEALTH CARE INC
Entity type:Organization
Organization Name:WEST VALLEY HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-785-5411
Mailing Address - Street 1:PO BOX 70716
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84170-0716
Mailing Address - Country:US
Mailing Address - Phone:801-969-1360
Mailing Address - Fax:801-969-1490
Practice Address - Street 1:5474 W 3500 S
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-2700
Practice Address - Country:US
Practice Address - Phone:801-969-1360
Practice Address - Fax:801-969-1490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2006-HHA-397251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========002Medicaid
UT467051Medicare Oscar/Certification