Organization Name: | MOUNTAIN MEDICAL URGENT CARE |
NPI Number: | 1093834038 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN R. PACK (OWNER) |
Mailing Address: | 127 East Main Street Suite E Lehi |
State: | UT US |
Postal Code: | 84043 |
Phone Number: | 8017681555 |
Fax Number: | 8017681569 |
NPI Enumeration Date: | 03/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0002X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Emergency Care |
Taxonomy Definition: |