| Mtchc Logan Clinic | |
|
550 E 1400 N Ste Xy Logan UT 84341-2406 | |
| (801) 393-5355 | |
| (801) 394-4609 |
| Full Name | Mtchc Logan Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 550 E 1400 N Ste Xy, Logan, Utah |
| Authorized Official Name and Position | Sonja Levesque (CFO) |
| Authorized Official Contact | 8013341327 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mtchc Logan Clinic 550 E 1400 N Ste Xy Logan UT 84341-2406 Ph: (801) 393-5355 | Mtchc Logan Clinic 550 E 1400 N Ste Xy Logan UT 84341-2406 Ph: (801) 393-5355 |
| NPI Number | 1053780171 |
|---|---|
| Provider Enumeration Date | 09/18/2015 |
| Last Update Date | 11/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053780171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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