| Senior Charity Care Foundation | |
|
1555 S 2200 W Ste B West Valley City UT 84119-8411 | |
| (801) 515-0480 | |
| Not Available |
| Full Name | Senior Charity Care Foundation |
|---|---|
| Speciality | Dentist |
| Location | 1555 S 2200 W, West Valley City, Utah |
| Authorized Official Name and Position | Terry Foust (PRESIDENT) |
| Authorized Official Contact | 8017182563 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Charity Care Foundation 721 N Main St # 106 Layton UT 84041-2231 Ph: (801) 515-0480 | Senior Charity Care Foundation 1555 S 2200 W Ste B West Valley City UT 84119-8411 Ph: (801) 515-0480 |
| NPI Number | 1215403456 |
|---|---|
| Provider Enumeration Date | 10/15/2018 |
| Last Update Date | 06/14/2022 |
| Medicare PECOS PAC ID | 5092123547 |
|---|---|
| Medicare Enrollment ID | O20210421001780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215403456 | NPI | - | NPPES |
| Provider Name | Keith J. Castleton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730168071 PECOS PAC ID: 0840345260 Enrollment ID: I20111022000072 |
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