SAN JUAN COUNTY HOSPITAL NPI 1659315877

NPI Information

NPI: 1659315877
Provider Name: SAN JUAN COUNTY HOSPITAL

Doing Business As: SAN JUAN CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
380 W 100 N
SUITE A
MONTICELLO, UT
ZIP 84535
Phone: (435) 587-5054
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SAN JUAN COUNTY HOSPITAL is a rural health clinic center in Monticello, UT. SAN JUAN COUNTY HOSPITAL NPI is 1659315877. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As San Juan Clinic.

The provider's business location address is:

380 W 100 N
SUITE A
MONTICELLO, UT
ZIP 84535-054
Phone: (435) 587-5054
Fax: (435) 587-3004

The provider's authorized official is Lyman Duncan .
The authorized official title is Cfo and has the following contact phone number (435) 587-2116.

The CLIA number assigned to this NPI record is 46D0960484 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/16/2006 and was last updated on 4/16/2014.

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	207Q00000X	Family Medicine		2005-HOSP-203	UTAH	No
2	261QR1300X	Clinic/Center	Rural Health	2011-HOSP-203	UTAH	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	=========117	MEDICAID	UTAH
2	463993	MEDICARE OSCAR/CERTIFICATION	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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