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COMPLETE CARE CLINIC PLLC NPI 1639196710


NPI Information

NPI: 1639196710
Provider Name: COMPLETE CARE CLINIC PLLC
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization

CLIA Number: 46D0888472

Address:
15 N 100 E
TOOELE, UT
ZIP 84074
Phone: (435) 882-6618
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COMPLETE CARE CLINIC PLLC is a preferred provider organization in Tooele, UT. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. COMPLETE CARE CLINIC PLLC NPI is 1639196710. The provider is registered as an organization entity type.

The provider's business location address is:

15 N 100 E
TOOELE, UT
ZIP 84074-101
Phone: (435) 882-6618
Fax: (435) 843-3774

The provider's authorized official is Paul Anthony Satter .
The authorized official title is Owner and has the following contact phone number (435) 882-6618.

The CLIA number assigned to this NPI record is 46D0888472 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/16/2006 and was last updated on 5/27/2015.


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
1305R00000XPreferred Provider Organization2807191205UTAHYes

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
1G37625MEDICARE UPINUTAH
2261517430001MEDICAIDUTAH
3005715601MEDICARE ID-TYPE UNSPECIFIEDUTAH

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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