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570 E Moqui Ln Escalante UT 84726-0276 | |
(435) 826-4374 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 570 E Moqui Ln, Escalante, Utah |
Authorized Official Name and Position | Evan Christensen (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4354253744 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 303 Bicknell UT 84715-0303 Ph: (435) 425-3744 | 570 E Moqui Ln Escalante UT 84726-0276 Ph: (435) 826-4374 |
NPI Number | 1568886000 |
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Provider Enumeration Date | 02/04/2014 |
Last Update Date | 04/21/2021 |
Medicare PECOS PAC ID | 1254242233 |
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Medicare Enrollment ID | O20140414001659 |
Identifier | Type | State | Issuer |
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1568886000 | NPI | - | NPPES |
000055193 | Other | UT | MEDICARE PART B - |