| Bear Lake Community Health Center, Inc. | |
|
325 W. Logan Hwy Garden City UT 84028-0328 | |
| (435) 946-3660 | |
| (435) 946-8215 |
| Full Name | Bear Lake Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 325 W. Logan Hwy, 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 W. Logan Hwy Garden City UT 84028-0328 Ph: (435) 946-3660 |
| NPI Number | 1689754475 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 06/01/2022 |
| Medicare PECOS PAC ID | 9032020037 |
|---|---|
| Medicare Enrollment ID | O20040110000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689754475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Glenn L Robertson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144281122 PECOS PAC ID: 3870517618 Enrollment ID: I20060119000899 |
| Provider Name | Suezan L Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770513962 PECOS PAC ID: 0749290781 Enrollment ID: I20060504000437 |
| Provider Name | Florin R Nielsen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508811639 PECOS PAC ID: 2668542184 Enrollment ID: I20080610000156 |
| Provider Name | Callin Passey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508020363 PECOS PAC ID: 1951450485 Enrollment ID: I20090512000639 |
| Provider Name | Ben Peter Boyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477703338 PECOS PAC ID: 4082760202 Enrollment ID: I20090914000126 |
| Provider Name | Michael D Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922005347 PECOS PAC ID: 2860474368 Enrollment ID: I20110823000128 |
| Provider Name | Sydnie Hobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033603345 PECOS PAC ID: 5395095806 Enrollment ID: I20180904002844 |
| Provider Name | Nancy Weston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538687967 PECOS PAC ID: 5890045298 Enrollment ID: I20180905003787 |
| Provider Name | Ian Michael Troesoyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841859501 PECOS PAC ID: 9032447701 Enrollment ID: I20190820002653 |
| Provider Name | Phillip Edward Archibald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396103487 PECOS PAC ID: 1355671249 Enrollment ID: I20190918003277 |
| Provider Name | Stephen M Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831457258 PECOS PAC ID: 0345570636 Enrollment ID: I20190930003266 |
| Provider Name | Matthew J Edrington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669716924 PECOS PAC ID: 3072924299 Enrollment ID: I20201119001308 |
| Provider Name | Mark Weston |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1114016250 PECOS PAC ID: 6204131295 Enrollment ID: I20210901002125 |
| Provider Name | Nathan Zurcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164085676 PECOS PAC ID: 8729478649 Enrollment ID: I20211209000030 |
| Provider Name | Mark Andrew Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821784125 PECOS PAC ID: 4486016318 Enrollment ID: I20230809002856 |
| Provider Name | Cal Morrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457614331 PECOS PAC ID: 3072737758 Enrollment ID: I20230824000896 |
Health West, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 325 W Logan Rd, Garden City, UT 84028 Phone: 435-946-3660 | |
Bear Lake County Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 288 S. Paradise Parkway, Garden City, UT 84028 Phone: 208-847-1630 | |
Bear Lake Community Health Center Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 West Logan Hwy., Garden City, UT 84028 Phone: 435-946-2770 Fax: 435-946-2781 |