Mountain Ridge Healthcare Pllc | |
2135 W Main St Ste B105 Lehi UT 84043-6936 | |
(801) 663-1296 | |
Not Available |
Full Name | Mountain Ridge Healthcare Pllc |
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Speciality | Family Medicine |
Location | 2135 W Main St Ste B105, Lehi, Utah |
Authorized Official Name and Position | Chad Lloyd Roberts (PHYSICIAN / BUSINESS OWNER) |
Authorized Official Contact | 8016631296 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mountain Ridge Healthcare Pllc 174 S 600 E Alpine UT 84004-1724 Ph: (801) 663-1296 | Mountain Ridge Healthcare Pllc 2135 W Main St Ste B105 Lehi UT 84043-6936 Ph: (801) 663-1296 |
NPI Number | 1710695473 |
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Provider Enumeration Date | 11/11/2022 |
Last Update Date | 11/15/2022 |
Medicare PECOS PAC ID | 9739559873 |
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Medicare Enrollment ID | O20230105001725 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710695473 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Chad Lloyd Roberts |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952964330 PECOS PAC ID: 6406180603 Enrollment ID: I20220829003424 |
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