CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION NPI 1003275280

NPI Information

CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION is a multi-specialty clinic center in Salt Lake City, UT. CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION NPI is 1003275280. The provider is registered as an organization entity type.
The provider Is Doing Business As Sacred Circle Health Care.

The provider's business location address is:

660 S 200 E STE 250
SALT LAKE CITY, UT
ZIP 84111-846
Phone: (801) 359-2256
Fax: (801) 364-4392

The provider's authorized official is Virgil W Johnson .
The authorized official title is Council Chair and has the following contact phone number (801) 898-4814.

The CLIA number assigned to this NPI record is 46D2287516 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/17/2016 and was last updated on 2/17/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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