| Virtare Health Physician Services Of Utah Pllc | |
|
1100 E 6600 S Suite 180 Salt Lake City UT 84121 | |
| (855) 745-8400 | |
| Not Available |
| Full Name | Virtare Health Physician Services Of Utah Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1100 E 6600 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Franklin Moses (CEO) |
| Authorized Official Contact | 8557458400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virtare Health Physician Services Of Utah Pllc 10890 Thornmint Rd San Diego CA 92127-2402 Ph: (855) 734-8400 | Virtare Health Physician Services Of Utah Pllc 1100 E 6600 S Suite 180 Salt Lake City UT 84121 Ph: (855) 745-8400 |
| NPI Number | 1164286761 |
|---|---|
| Provider Enumeration Date | 02/13/2024 |
| Last Update Date | 10/14/2024 |
| Medicare PECOS PAC ID | 7719328236 |
|---|---|
| Medicare Enrollment ID | O20240515003162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164286761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kimberly K Weggemann Holder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124674460 PECOS PAC ID: 0648604066 Enrollment ID: I20200316002767 |
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