Midtown Community Health Center INC
Clinic/Center, Federally Qualified Health Center (FQHC) in Logan, UT. Organization (NPI-2).
NPI number1053780171
StatusActive
Last updated in NPPESNov 30, 2018
Details
- NPI
- 1053780171
- Entity type
- Organization (NPI-2)
- Legal business name
- Midtown Community Health Center INC
- Organization subpart
- No
- Enumeration date
- Sep 18, 2015
- Last updated
- Nov 30, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
| 261QC1500X | Clinic/Center, Community Health | – | – |
Other names
- Mtchc Logan Clinic (Doing Business As)
Practice location
550 E 1400 N Ste XyLogan, UT 84341-2406
Phone 801-393-5355 · Fax 801-394-4609
Mailing address
550 E 1400 N Ste XyLogan, UT 84341-2406
Phone 801-393-5355 · Fax 801-394-4609
Authorized official
Sonja Levesque
Cfo
8013341327
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