Revere Health

LBN: Central Utah Clinic, P.C.
Revere Health is an health care organization with primary practice located at 97 S Professional Way Suite 2, Payson UT 84651-1614. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Central Utah Clinic, P.C. can be contacted via phone (801) 465-4896, or through Harston, Jed via phone (801) 812-5012.

Contact Information

Primary practice address
97 S Professional Way Suite 2 Payson UT 84651-1614
Phone: (801) 465-4896
Fax: (801) 465-4107
Website:
Map and Directions
Authorized official contact:
Name: Harston, Jed
Phone: (801) 812-5012

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1508896838
LBN Legal business name Central Utah Clinic, P.C.
DBA Doing business as Revere Health
Authorized official Harston, Jed
Entity Organization
Organization subpart 1 No
Enumeration date Jul 3rd, 2006
Last updated Mar 7th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508896838 NPPES
Utah MEDICAID 870609595000

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