Provider Demographics
NPI:1841212818
Name:HOSPICE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:HOSPICE SPECIALISTS, LLC
Other - Org Name:HORIZON HOSPICE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:BENSON
Authorized Official - Last Name:WOOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:801-225-7171
Mailing Address - Street 1:11 E 200 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4764
Mailing Address - Country:US
Mailing Address - Phone:801-225-7171
Mailing Address - Fax:801-225-7977
Practice Address - Street 1:6000 S FASHION BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5437
Practice Address - Country:US
Practice Address - Phone:801-293-8700
Practice Address - Fax:801-293-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2006-HOSPICE-76453251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100503002Medicaid
NV100505918Medicaid
UT=========001Medicaid
UT461512AMedicare Oscar/Certification