Be Well Medical | |
3935 N 75 W Hyde Park UT 84318-4111 | |
(435) 359-0720 | |
Not Available |
Full Name | Be Well Medical |
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Speciality | Clinic/Center |
Location | 3935 N 75 W, Hyde Park, Utah |
Authorized Official Name and Position | Andrea Lee Skates (FNP/OPERATIONS MANAGER) |
Authorized Official Contact | 4353590720 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Be Well Medical 41 E 400 N # 322 Logan UT 84321-4020 Ph: (435) 359-0720 | Be Well Medical 3935 N 75 W Hyde Park UT 84318-4111 Ph: (435) 359-0720 |
NPI Number | 1669092169 |
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Provider Enumeration Date | 04/24/2020 |
Last Update Date | 08/14/2020 |
Medicare PECOS PAC ID | 8224454293 |
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Medicare Enrollment ID | O20200820002919 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669092169 | NPI | - | NPPES |
1972990828 | Medicaid | UT | |
1811519085 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Andrea L Skates |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972990828 PECOS PAC ID: 7214244417 Enrollment ID: I20150921002775 |
Provider Name | Savannah Alder |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811519085 PECOS PAC ID: 2567882665 Enrollment ID: I20201012000590 |
Provider Name | Kimberly Lynn Tagg |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801477286 PECOS PAC ID: 2860875143 Enrollment ID: I20220818003726 |
Provider Name | Elizabeth Nicole Halley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326738618 PECOS PAC ID: 5597122648 Enrollment ID: I20230605001254 |
North Cache Valley Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4088 N Highway 91, Hyde Park, UT 84318 Phone: 435-563-4900 |