| Central Utah Clinic Pc | |
|
972 N 600 E Spanish Fork UT 84660-1306 | |
| (801) 373-7350 | |
| (801) 812-5401 |
| Full Name | Central Utah Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 972 N 600 E, Spanish Fork, Utah |
| Authorized Official Name and Position | Jed Bradley Harston (DIRECTOR OF PAYER RELATIONS) |
| Authorized Official Contact | 8018125012 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Utah Clinic Pc 1055 N 500 W Att Credentialing Provo UT 84604 Ph: (801) 354-8225 | Central Utah Clinic Pc 972 N 600 E Spanish Fork UT 84660-1306 Ph: (801) 373-7350 |
| NPI Number | 1851142285 |
|---|---|
| Provider Enumeration Date | 04/01/2024 |
| Last Update Date | 04/01/2024 |
| Medicare PECOS PAC ID | 7517868508 |
|---|---|
| Medicare Enrollment ID | O20240508003356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851142285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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