State Of Utah

LBN: Health Clinics Of Utah
State Of Utah is an health care organization with primary practice located at 150 E. Center St. #1100, Provo UT 84606. The organization recently has only one registered license in Ambulatory Health Care Facilities / Public Health, State or Local, which is considered as the primary health care specialty. Health Clinics Of Utah can be contacted via phone (801) 374-7011, or through Keyes, Stacey Marie via phone (801) 626-3353.

Contact Information

Primary practice address
150 E. Center St. #1100 Provo UT 84606
Phone: (801) 374-7011
Fax: (801) 374-7009
Website:
Map and Directions
Authorized official contact:
Name: Keyes, Stacey Marie CPC
Phone: (801) 626-3353

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Public Health, State or Local 261QP0905X 1610961205 Utah
Ambulatory Health Care Facilities / Public Health, State or Local 261QP0905X 105991-1206 Utah
Ambulatory Health Care Facilities / Public Health, State or Local 261QP0905X 285456-4405 Utah

Profile Details

NPI number 1982669982
LBN Legal business name Health Clinics Of Utah
DBA Doing business as State Of Utah
Authorized official Keyes, Stacey Marie CPC
Entity Organization
Organization subpart 1 No
Enumeration date Apr 20th, 2006
Last updated May 18th, 2012 - about 13 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 1982669982 NPPES
Utah MEDICAID 05664
Utah MEDICAID 05665
Utah MEDICAID 535501136001

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