NPI 1124242128

Caresource

Organisation Hospice and Palliative Medicine (Family Medicine) Physician Salt Lake City, UT

Practice location

Address: 1624 E 4500 S, Salt Lake City, UT 84117-4212
Phone: (801) 266-7200
Fax: (801) 266-7004

Authorised official

Name: Shawntel Tanner
Title: Administrator
Phone: (801) 266-7200

Registered specialties (2)

Hospice and Palliative Medicine (Family Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QH0002X Licence 5221090-1205 (UT)

Other Family Medicine providers in Utah →

Family Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 5221090-1205 (UT)

Registry record

NPI: 1124242128
Entity type: Organization
NPI issued: 12 Apr 2007
Record last updated: 11 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.