| Revere Health | |
|
555 W Sr 164 Salem UT 84653 | |
| (801) 429-8000 | |
| Not Available |
| Full Name | Revere Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 555 W Sr 164, Salem, Utah |
| Authorized Official Name and Position | Jed Harston (DIRECTOR OF MANAGED CARE) |
| Authorized Official Contact | 8018125012 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revere Health 1055 N 500 W Attn: Credentialing Provo UT 84604-3305 Ph: (801) 354-8225 | Revere Health 555 W Sr 164 Salem UT 84653 Ph: (801) 429-8000 |
| NPI Number | 1942233986 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 01/14/2020 |
| Medicare PECOS PAC ID | 7517868508 |
|---|---|
| Medicare Enrollment ID | O20131209000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942233986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Canyon View Medical Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 591 N State Road 198 Ste 202, Salem, UT 84653 Phone: 801-465-9802 Fax: 801-798-8513 | |
Revere Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 W Sr 164, Salem, UT 84653 Phone: 801-429-8000 | |
Hillside Medical Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 118 N Main St Ste B, Salem, UT 84653 Phone: 801-477-9007 Fax: 801-477-9006 |