Provider Demographics
NPI:1073848230
Name:SPECIALIZED HOME HEALTH, LLC
Entity Type:Organization
Organization Name:SPECIALIZED HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ELLIS
Authorized Official - Last Name:BUNN
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:801-404-3528
Mailing Address - Street 1:361 E 1200 S STE 201
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6904
Mailing Address - Country:US
Mailing Address - Phone:801-404-3528
Mailing Address - Fax:801-224-4914
Practice Address - Street 1:361 E 1200 S STE 201
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6904
Practice Address - Country:US
Practice Address - Phone:801-404-3528
Practice Address - Fax:801-224-4914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health