WASATCH HOMELESS HEALTH CARE INC. NPI 1528128899

NPI Information

NPI: 1528128899
Provider Name: WASATCH HOMELESS HEALTH CARE, INC.

Doing Business As: FOURTH STREET CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
409 W 400 S
SALT LAKE CITY, UT
ZIP 84101
Phone: (801) 364-0058
Get Directions

WASATCH HOMELESS HEALTH CARE, INC. is a federally qualified health center (fqhc) clinic center in Salt Lake City, UT. WASATCH HOMELESS HEALTH CARE, INC. NPI is 1528128899. The provider is registered as an organization entity type.
The provider Is Doing Business As Fourth Street Clinic.

The provider's business location address is:

409 W 400 S
SALT LAKE CITY, UT
ZIP 84101-135
Phone: (801) 364-0058
Fax: (801) 364-0161

The provider's authorized official is Janida Emerson .
The authorized official title is Ceo and has the following contact phone number (801) 364-0058.

The CLIA number assigned to this NPI record is 46D0856838 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/9/2006 and was last updated on 11/24/2020.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	201375	OTHER	UTAH	BLACK LUNG
2	W0210	MEDICAID	UTAH

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

NPI Synchronization or Removal

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