Provider Demographics
NPI:1548680598
Name:CNS PROFESSIONAL SERVICES
Entity type:Organization
Organization Name:CNS PROFESSIONAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:R.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ACTON
Authorized Official - Suffix:
Authorized Official - Credentials:MACC
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 1:3685 W 6200 S
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129-3731
Practice Address - Country:US
Practice Address - Phone:801-973-0900
Practice Address - Fax:801-708-7866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8554383-1714332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT0611610001Medicare NSC