Provider Demographics
NPI:1003296070
Name:PALLIATIVE MEDICINE ASSOCIATES LLC
Entity Type:Organization
Organization Name:PALLIATIVE MEDICINE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NINO
Authorized Official - Middle Name:
Authorized Official - Last Name:CALFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-750-6466
Mailing Address - Street 1:888 E 3900 S
Mailing Address - Street 2:SUITE B
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2151
Mailing Address - Country:US
Mailing Address - Phone:801-747-0330
Mailing Address - Fax:
Practice Address - Street 1:888 E 3900 S
Practice Address - Street 2:SUITE B
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2151
Practice Address - Country:US
Practice Address - Phone:801-747-0330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health