Bear Lake Community Health Center, Inc. in Providence - Federally Qualified Health Center (fqhc)
Bear Lake Community Health Center, Inc. - NPI 1063630705
Bear Lake Community Health Center, Inc. is a Federally Qualified Health Center (fqhc) in Providence, Utah. Bear Lake Community Health Center, Inc. practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for Bear Lake Community Health Center, Inc. is 1063630705. The last update date is 2022-06-01.
Bear Lake Community Health Center, Inc.'s current location address is 517 W 100 N Ste 210, Providence, Utah. You can contact this provider via phone number 4359463660. The mailing address for Bear Lake Community Health Center, Inc. is 517 W 100 N Ste 210, Providence, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Bear Lake Community Health Center, Inc. |
|---|---|
| Address | 517 W 100 N Ste 210, Providence, Utah |
| Phone Number | 4359463660 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Garcia Jorge |
| Telephone Number | 4357556061 |
NPI Number Detail
| NPI Number | 1063630705 |
|---|---|
| Provider Enumeration Date | 2007-04-20 |
| Last Updated Date | 2022-06-01 |
Provider Mailing Address Detail
| Address | 517 W 100 N Ste 210 |
|---|---|
| City | Providence |
| State | Utah (UT) |
| Post Code | 843329826 |
| Phone Number | 4359463660 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Federally Qualified Health Center (fqhc) |
|---|---|
| Taxonomy | 261Qf0400X |
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Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
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What is the unique 10-digit identifier code assigned to Bear Lake Community Health Center, Inc. by the Centers for Medicare & Medicaid Services?
The Bear Lake Community Health Center, Inc. has been issued the NPI (National Provider Identifier) 1063630705 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Bear Lake Community Health Center, Inc. located?
The Bear Lake Community Health Center, Inc. is located at 517 W 100 N Ste 210, Providence, UT 843329826.
What is Bear Lake Community Health Center, Inc.'s specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Bear Lake Community Health Center, Inc.'s specialized field of practice is Federally Qualified Health Center (fqhc), and the corresponding taxonomy code that categorizes this area of specialization is 261Qf0400X.
On what date did the Bear Lake Community Health Center, Inc. receive the assignment of its 1063630705 from the Centers for Medicare & Medicaid Services?
The Bear Lake Community Health Center, Inc. was issued its 1063630705 by the Centers for Medicare & Medicaid Services on 2007-04-20.
When was the information related to Bear Lake Community Health Center, Inc. most recently updated or refreshed?
The details pertaining to the Bear Lake Community Health Center, Inc., including its address, specialty, and other relevant information, were last updated or refreshed on 2022-06-01.