Provider Demographics
NPI:1861907685
Name:ADVANCED VETERINARY CARE, INC.
Entity type:Organization
Organization Name:ADVANCED VETERINARY CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-942-3951
Mailing Address - Street 1:1021 E 3300 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-2142
Mailing Address - Country:US
Mailing Address - Phone:801-942-3951
Mailing Address - Fax:801-485-2306
Practice Address - Street 1:1021 E 3300 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2142
Practice Address - Country:US
Practice Address - Phone:801-942-3951
Practice Address - Fax:801-485-2306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6814174-0142207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty