Integrated Primary Care Llc | |
3018 E 3300 S Salt Lake City UT 84109-2144 | |
(801) 419-0705 | |
(801) 606-7902 |
Full Name | Integrated Primary Care Llc |
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Speciality | General Practice |
Location | 3018 E 3300 S, Salt Lake City, Utah |
Authorized Official Name and Position | Sharlene Watson (OWNER) |
Authorized Official Contact | 8014190705 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Integrated Primary Care Llc 3018 E 3300 S Salt Lake City UT 84109-2144 Ph: (801) 419-0705 | Integrated Primary Care Llc 3018 E 3300 S Salt Lake City UT 84109-2144 Ph: (801) 419-0705 |
NPI Number | 1659886950 |
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Provider Enumeration Date | 12/08/2017 |
Last Update Date | 01/26/2018 |
Medicare PECOS PAC ID | 8022379395 |
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Medicare Enrollment ID | O20180301000437 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659886950 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Stanley Morris Gardner |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1932242690 PECOS PAC ID: 5294096574 Enrollment ID: I20180301000509 |
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