| Dvora Healthcare LLC | |
|
8180 S 700 E Ste 130 Sandy UT 84070-0568 | |
| (801) 407-9409 | |
| (801) 341-9794 |
| Full Name | Dvora Healthcare LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 8180 S 700 E Ste 130, Sandy, Utah |
| Authorized Official Name and Position | Colby Haderlie (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8014079409 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dvora Healthcare LLC 8180 S 700 E Ste 130 Sandy UT 84070-0568 Ph: (801) 407-9409 | Dvora Healthcare LLC 8180 S 700 E Ste 130 Sandy UT 84070-0568 Ph: (801) 407-9409 |
| NPI Number | 1538023882 |
|---|---|
| Provider Enumeration Date | 12/11/2025 |
| Last Update Date | 12/11/2025 |
| Certification Date | 12/11/2025 |
| Medicare PECOS PAC ID | 2860972262 |
|---|---|
| Medicare Enrollment ID | O20260216000964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538023882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | () | Primary |
| Provider Name | Rachael Stubbs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568489375 PECOS PAC ID: 7416943246 Enrollment ID: I20040426000338 |
| Provider Name | Kimberly Ann Henne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780248336 PECOS PAC ID: 8527392489 Enrollment ID: I20190626001673 |
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