| Anodyne Of Park City Llc | |
|
1790 Sun Peak Dr Ste A102 Park City UT 84098-6651 | |
| (435) 640-1353 | |
| (435) 655-2984 |
| Full Name | Anodyne Of Park City Llc |
|---|---|
| Speciality | General Practice |
| Location | 1790 Sun Peak Dr Ste A102, Park City, Utah |
| Authorized Official Name and Position | Greg Simons (CEO) |
| Authorized Official Contact | 4356401353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anodyne Of Park City Llc 1790 Sun Peak Dr Ste A102 Park City UT 84098-6651 Ph: (435) 640-1353 | Anodyne Of Park City Llc 1790 Sun Peak Dr Ste A102 Park City UT 84098-6651 Ph: (435) 640-1353 |
| NPI Number | 1043970866 |
|---|---|
| Provider Enumeration Date | 12/20/2021 |
| Last Update Date | 12/20/2021 |
| Medicare PECOS PAC ID | 2466844402 |
|---|---|
| Medicare Enrollment ID | O20220124002806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043970866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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