| Bear Lake Community Health Center, Inc. | |
|
325 West Logan Highway Garden City UT 84028-8001 | |
| (435) 946-3660 | |
| (435) 946-8215 |
| Full Name | Bear Lake Community Health Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 325 West Logan Highway, Garden City, Utah |
| Authorized Official Name and Position | Jorge Garcia (CEO) |
| Authorized Official Contact | 4357556061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bear Lake Community Health Center, Inc. 517 W 100 N Ste 210 Providence UT 84332-9826 Ph: (435) 755-6061 | Bear Lake Community Health Center, Inc. 325 West Logan Highway Garden City UT 84028-8001 Ph: (435) 946-3660 |
| NPI Number | 1629309786 |
|---|---|
| Provider Enumeration Date | 01/28/2010 |
| Last Update Date | 06/06/2022 |
| Certification Date | 06/06/2022 |
| Medicare PECOS PAC ID | 9032020037 |
|---|---|
| Medicare Enrollment ID | O20111110000031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629309786 | NPI | - | NPPES |
| Provider Name | Michael D Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922005347 PECOS PAC ID: 2860474368 Enrollment ID: I20111110000249 |
| Provider Name | Eric N. Swensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700013661 PECOS PAC ID: 3870741218 Enrollment ID: I20120910000836 |
| Provider Name | Mandi Elizabeth Lew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568829109 PECOS PAC ID: 6709172943 Enrollment ID: I20190129003051 |
| Provider Name | Stephen M Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831457258 PECOS PAC ID: 0345570636 Enrollment ID: I20190930002664 |
| Provider Name | Phillip Edward Archibald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396103487 PECOS PAC ID: 1355671249 Enrollment ID: I20191015000191 |
| Provider Name | Glenn L Robertson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144281122 PECOS PAC ID: 3870517618 Enrollment ID: I20200505002134 |
| Provider Name | Jaden Bingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982293197 PECOS PAC ID: 3870900640 Enrollment ID: I20210322002740 |
| Provider Name | Brianne Emory Stringer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871234765 PECOS PAC ID: 6002293263 Enrollment ID: I20220510001420 |
| Provider Name | Nathan Zurcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164085676 PECOS PAC ID: 8729478649 Enrollment ID: I20220628001967 |
| Provider Name | Nancy Weston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538687967 PECOS PAC ID: 5890045298 Enrollment ID: I20220711000936 |