Revere Health | |
736 S 900 E Ste 203 St George UT 84790-7003 | |
(435) 673-6131 | |
(435) 673-8557 |
Full Name | Revere Health |
---|---|
Speciality | Family Medicine |
Location | 736 S 900 E Ste 203, St George, Utah |
Authorized Official Name and Position | Jed Harston (DIRECTOR OF MANAGED CARE) |
Authorized Official Contact | 8018125012 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Revere Health 1055 N 500 W Attn: Credentialing Provo UT 84604-3305 Ph: (801) 354-8225 | Revere Health 736 S 900 E Ste 203 St George UT 84790-7003 Ph: (435) 673-6131 |
NPI Number | 1295829281 |
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Provider Enumeration Date | 10/03/2006 |
Last Update Date | 03/07/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295829281 | NPI | - | NPPES |
46D0525920 | Other | UT | CLIA NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Utah) | Primary |
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