Caresource
Caresource is a Family Medicine Physician in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2007.
- Licensed in
- UT
- In the registry since
- 2007
- Specialties on file
- 2
Practice location Address checks out
1624 E 4500 SSalt Lake City, UT 84117-4212
Phone: (801) 266-7200
Fax: (801) 266-7004
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Hospice and Palliative Medicine (Family Medicine) Physician (primary) | Taxonomy 207QH0002X · Licence 5221090-1205 (UT) |
|---|---|
| Family Medicine Physician | Taxonomy 207Q00000X · Licence 5221090-1205 (UT) |
Record details
| NPI number | 1124242128 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Shawntel Tanner — Administrator · (801) 266-7200 |
| Other names | Caresource Senior Supportive Care Center |
| NPI enumerated | April 12, 2007 |
| Last updated in NPPES | September 11, 2025 |
| Mailing address | 1624 E 4500 S, Salt Lake City, UT 84117-4212 |
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