Provider Demographics
NPI:1902855083
Name:COMMUNITY NURSING SERVICE
Entity Type:Organization
Organization Name:COMMUNITY NURSING SERVICE
Other - Org Name:CNS COMMUNITY HOSPICE, CNS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:D
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-233-6100
Mailing Address - Street 1:2830 S REDWOOD RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-5625
Mailing Address - Country:US
Mailing Address - Phone:801-233-6100
Mailing Address - Fax:801-233-6110
Practice Address - Street 1:480 S CARBON AVE
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-3227
Practice Address - Country:US
Practice Address - Phone:435-613-8887
Practice Address - Fax:435-613-8890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2015-HOSPICE-416251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========011Medicaid
UT461557Medicare Oscar/Certification