| Granger Medical Clinic Pc | |
|
3181 W 9000 So West Jordan UT 84088 | |
| (801) 352-5900 | |
| (801) 352-5914 |
| Full Name | Granger Medical Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3181 W 9000 So, West Jordan, Utah |
| Authorized Official Name and Position | Mary Jane Pennington (PRESIDENT) |
| Authorized Official Contact | 8019653600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Granger Medical Clinic Pc 2965 W 3500 S West Valley City UT 84119-3602 Ph: (801) 965-3600 | Granger Medical Clinic Pc 3181 W 9000 So West Jordan UT 84088 Ph: (801) 352-5900 |
| NPI Number | 1104857549 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 09/02/2025 |
| Medicare PECOS PAC ID | 3476465691 |
|---|---|
| Medicare Enrollment ID | O20100930071545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104857549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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