Provider Demographics
NPI:1225217896
Name:HUDSON HOME HEALTH
Entity Type:Organization
Organization Name:HUDSON HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-898-6425
Mailing Address - Street 1:62 N GRANT AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-1728
Mailing Address - Country:US
Mailing Address - Phone:801-898-6425
Mailing Address - Fax:800-294-1685
Practice Address - Street 1:62 N GRANT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-1728
Practice Address - Country:US
Practice Address - Phone:801-898-6425
Practice Address - Fax:800-294-1685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTV21218332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6076260002Medicare NSC