Provider Demographics
NPI:1770295438
Name:PRIMARY HOME HEALTH
Entity type:Organization
Organization Name:PRIMARY HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOLMGREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-243-7333
Mailing Address - Street 1:39 PIER PL
Mailing Address - Street 2:
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-4918
Mailing Address - Country:US
Mailing Address - Phone:801-243-7333
Mailing Address - Fax:801-890-3434
Practice Address - Street 1:3300 N RUNNING CREEK WAY STE 250
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5563
Practice Address - Country:US
Practice Address - Phone:801-980-0033
Practice Address - Fax:801-980-4133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health