1477333417 NPI number — SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC

Table of content: (NPI 1477333417)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477333417 NPI number — SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FAMILY HEALTHCARE-HURRICANE PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477333417
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2276 E RIVERSIDE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT GEORGE
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84790-2636
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-986-2565
Provider Business Mailing Address Fax Number:
435-310-5177

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
391 N 200 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HURRICANE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84737-1616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-359-9899
Provider Business Practice Location Address Fax Number:
435-310-5177
Provider Enumeration Date:
10/05/2023

Additional Information

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
435-986-2565

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com