Provider Demographics
NPI:1053780825
Name:ROCKY MOUNTAIN HOME CARE AND HOSPICE WYOMING, LLC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN HOME CARE AND HOSPICE WYOMING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGERTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-397-4000
Mailing Address - Street 1:5242 S COLLEGE DR
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2653
Mailing Address - Country:US
Mailing Address - Phone:801-397-4000
Mailing Address - Fax:
Practice Address - Street 1:5242 S COLLEGE DR
Practice Address - Street 2:SUITE 340
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-2653
Practice Address - Country:US
Practice Address - Phone:801-397-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based