Provider Demographics
NPI:1730562208
Name:OHANA HOSPICE
Entity type:Organization
Organization Name:OHANA HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFGRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-231-8811
Mailing Address - Street 1:PO BOX 1494
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-8494
Mailing Address - Country:US
Mailing Address - Phone:801-903-2595
Mailing Address - Fax:801-999-7157
Practice Address - Street 1:623 E FORT UNION BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-5528
Practice Address - Country:US
Practice Address - Phone:801-903-2595
Practice Address - Fax:801-999-7157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based