GRANGER MEDICAL CLINIC PC NPI 1073811733

NPI Information

NPI: 1073811733
Provider Name: GRANGER MEDICAL CLINIC PC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 46D2124743

Address:
2356 N 400 E STE 201
TOOELE, UT
ZIP 84074
Phone: (801) 352-5900
Get Directions

GRANGER MEDICAL CLINIC PC is a multi-specialty clinic center in Tooele, UT. GRANGER MEDICAL CLINIC PC NPI is 1073811733. The provider is registered as an organization entity type.

The provider's business location address is:

2356 N 400 E STE 201
TOOELE, UT
ZIP 84074-409
Phone: (801) 352-5900
Fax: (801) 352-5914

The provider's authorized official is Mary Jane Pennington .
The authorized official title is President and has the following contact phone number (801) 965-3600.

The CLIA number assigned to this NPI record is 46D2124743 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/4/2011 and was last updated on 12/13/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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: 5/5/2024

NPI Synchronization or Removal

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