| Health West Providence | |
|
517 W 100 N Ste 110 Providence UT 84332-9826 | |
| (435) 213-4225 | |
| Not Available |
| Full Name | Health West Providence |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| 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 | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health West Providence 500 S 11th Ave Ste 400 Pocatello ID 83201-4880 Ph: (208) 232-7862 | Health West Providence 517 W 100 N Ste 110 Providence UT 84332-9826 Ph: (435) 213-4225 |
| NPI Number | 1528774452 |
|---|---|
| Provider Enumeration Date | 01/24/2023 |
| Last Update Date | 04/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528774452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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