Peak Medical Clinic, Llc | |
1486 E Skyline Dr Ste 200 Ogden UT 84405-4863 | |
(801) 436-5937 | |
(801) 610-7823 |
Full Name | Peak Medical Clinic, Llc |
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Speciality | Durable Medical Equipment & Medical Supplies |
Location | 1486 E Skyline Dr Ste 200, Ogden, Utah |
Authorized Official Name and Position | Charise Carlson (MANAGING MEMBER) |
Authorized Official Contact | 9072526357 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Peak Medical Clinic, Llc 1486 E Skyline Dr Ste 200 Ogden UT 84405-4863 Ph: (801) 436-5937 | Peak Medical Clinic, Llc 1486 E Skyline Dr Ste 200 Ogden UT 84405-4863 Ph: (801) 436-5937 |
NPI Number | 1336807486 |
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Provider Enumeration Date | 12/06/2021 |
Last Update Date | 06/20/2022 |
Medicare PECOS PAC ID | 9739571480 |
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Medicare Enrollment ID | O20220110001445 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336807486 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
Provider Name | Irma Clarita Rivera |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740731330 PECOS PAC ID: 4981972510 Enrollment ID: I20170622001131 |
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