72Nd Street Medical Clinic

LBN: Community Health Centers, Inc.
72Nd Street Medical Clinic is an health care organization with primary practice located at 220 W 7200 S Suite A, Midvale UT 84047-1043. The organization recently has 7 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Ambulatory Health Care Facilities / Multi-Specialty, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Community Health Centers, Inc. can be contacted via phone (801) 566-5494, or through Thomas, Jennifer Lyn via phone (801) 412-6920.

Contact Information

Primary practice address
220 W 7200 S Suite A Midvale UT 84047-1043
Fax: (877) 497-4661
Website:
Authorized official contact:
Name: Thomas, Jennifer Lyn

Profile Details

NPI number 1073611364
LBN Legal business name Community Health Centers, Inc.
DBA Doing business as 72Nd Street Medical Clinic
Authorized official Thomas, Jennifer Lyn
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2006
Last updated Oct 30th, 2023 - about 2 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 1073611364 NPPES
Utah MEDICAID 1073611364

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