Provider Demographics
NPI:1659708071
Name:VISITING PHYSICIAN SERVICES LLC
Entity Type:Organization
Organization Name:VISITING PHYSICIAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-400-3073
Mailing Address - Street 1:257 SOUTH OREM BLVD.
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-3009
Mailing Address - Country:US
Mailing Address - Phone:801-225-1080
Mailing Address - Fax:801-225-1069
Practice Address - Street 1:257 SOUTH OREM BLVD
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-3009
Practice Address - Country:US
Practice Address - Phone:801-225-1080
Practice Address - Fax:801-225-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty