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WASATCH HOMELESS HEALTH CARE INC. NPI 1043865074


NPI Information

NPI: 1043865074
Provider Name: WASATCH HOMELESS HEALTH CARE, INC.

Doing Business As: 4TH STREET CLINIC

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

Address:
409 WEST 400 SOUTH
SALT LAKE, UT
ZIP 84101
Phone: (385) 234-5708
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WASATCH HOMELESS HEALTH CARE, INC. is a clinic pharmacy pharmacy in Salt Lake, UT. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. WASATCH HOMELESS HEALTH CARE, INC. NPI is 1043865074. The provider is registered as an organization entity type.
The provider Is Doing Business As 4th Street Clinic.

The provider's business location address is:

409 WEST 400 SOUTH
SALT LAKE, UT
ZIP 84101
Phone: (385) 234-5708
Fax: (801) 433-0153

The provider's authorized official is Laura Michalski .
The authorized official title is Chief Executive Officer and has the following contact phone number (801) 364-0058.

The enumeration date for this NPI number is 8/6/2019 and was last updated on 8/19/2019.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0002XPharmacyClinic PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11528128899MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.