Full Name | |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 1400 N 500 E, Logan, Utah |
Authorized Official Name and Position | Denis Smith (CFO) |
Authorized Official Contact | 8014422000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 30180 Salt Lake City UT 84130-0180 Ph: () - | 1400 N 500 E Logan UT 84341-2455 Ph: (435) 716-1000 |
NPI Number | 1710996673 |
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Provider Enumeration Date | 08/07/2006 |
Last Update Date | 11/16/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710996673 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | 2005-HOSP-190 (Utah) | Primary |
Ihc Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 550 E 1400 N Ste Xy, Logan, UT 84341 Phone: 435-757-1315 | |
Bridge Utah Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1015 E 100 N, Logan, UT 84321 Phone: 888-221-0423 Fax: 888-221-9816 | |