SUNRISE FAMILY PRACTICE LLC NPI 1386135762

NPI Information

NPI: 1386135762
Provider Name: SUNRISE FAMILY PRACTICE LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 46D2149901

Address:
8785 S JORDAN VALLEY WAY # 100
WEST JORDAN, UT
ZIP 84088
Phone: (385) 645-7474
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SUNRISE FAMILY PRACTICE LLC is a primary care clinic center in West Jordan, UT. SUNRISE FAMILY PRACTICE LLC NPI is 1386135762. The provider is registered as an organization entity type.

The provider's business location address is:

8785 S JORDAN VALLEY WAY # 100
WEST JORDAN, UT
ZIP 84088-772
Phone: (385) 645-7474

The provider's authorized official is Jololene Allan .
The authorized official title is Owner and has the following contact phone number (385) 645-7474.

The CLIA number assigned to this NPI record is 46D2149901 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2018 and was last updated on 2/14/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	211972-4405	UTAH	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: 4/28/2024

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