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CENTRAL UTAH CLINIC P.C. NPI 1437205028


NPI Information

NPI: 1437205028
Provider Name: CENTRAL UTAH CLINIC, P.C.

Doing Business As: REVERE HEALTH

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 46D0938175

Address:
1175 E 50 S
SUITE 101
AMERICAN FORK, UT
ZIP 84003
Phone: (801) 492-5994
Get Directions

CENTRAL UTAH CLINIC, P.C. is an ambulatory surgical clinic center in American Fork, UT. CENTRAL UTAH CLINIC, P.C. NPI is 1437205028. The provider is registered as an organization entity type.
The provider Is Doing Business As Revere Health.

The provider's business location address is:

1175 E 50 S
SUITE 101
AMERICAN FORK, UT
ZIP 84003-000
Phone: (801) 492-5994
Fax: (801) 418-0899

The provider's authorized official is Jed Harston .
The authorized official title is Director Of Managed Care and has the following contact phone number (801) 812-5012.

The CLIA number assigned to this NPI record is 46D0938175 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2007 and was last updated on 3/7/2018.


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
1261QA1903XClinic/CenterAmbulatory Surgical2007ASF78284UTAHYes

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

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