<unavail> in Providence, UT - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Providence, Utah. The current practice location for is 517 W 100 N Ste 110, Providence, Utah. For appointments, you can reach them via phone at (435) 213-4225. The mailing address for is 500 S 11th Ave Ste 400, Pocatello, Idaho and phone number is (208) 232-7862.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1528774452. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (435) 213-4225.

Contact Information


	517 W 100 N Ste 110 Providence UT 84332-9826
	(435) 213-4225
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	517 W 100 N Ste 110, Providence, Utah
Authorized Official Name and Position	Amelia Murphy (MEDICAL STAFF COORDINATOR)
Authorized Official Contact	2082327862
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
500 S 11th Ave Ste 400 Pocatello ID 83201-4880 Ph: (208) 232-7862	517 W 100 N Ste 110 Providence UT 84332-9826 Ph: (435) 213-4225

NPI Details:

NPI Number	1528774452
Provider Enumeration Date	01/24/2023
Last Update Date	04/04/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	4981500931
Medicare Enrollment ID	O20240830003704

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1528774452	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary

Reviews and Comments

Clinic/Center in Providence, UT

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Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 517 W 100 N Ste 110, Providence, UT 84332 Phone: 435-755-6075 Fax: 435-994-8362
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- Medicare Primary Care in Providence, UT