Provider Demographics
NPI:1477939858
Name:INSPIRATION HOSPICE
Entity Type:Organization
Organization Name:INSPIRATION HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MARKETING
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MODESITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-671-7926
Mailing Address - Street 1:835 E 4800 S STE 110
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5531
Mailing Address - Country:US
Mailing Address - Phone:801-281-1314
Mailing Address - Fax:
Practice Address - Street 1:835 E 4800 S STE 110
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5531
Practice Address - Country:US
Practice Address - Phone:801-281-1314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2015-HHA-104131251E00000X
UT2015-HOSPICE-84853251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT841625893001Medicaid
UT461538Medicare Oscar/Certification