| Midtown Community Health Center Inc | |
|
60 E 3750 S South Salt Lake UT 84115-4428 | |
| (801) 486-0911 | |
| (833) 428-8495 |
| Full Name | Midtown Community Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 60 E 3750 S, South Salt Lake, Utah |
| Authorized Official Name and Position | Alicia Dacy Martinez (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8013341321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midtown Community Health Center Inc 2240 Adams Ave Ogden UT 84401-1511 Ph: (801) 393-5355 | Midtown Community Health Center Inc 60 E 3750 S South Salt Lake UT 84115-4428 Ph: (801) 486-0911 |
| NPI Number | 1033547567 |
|---|---|
| Provider Enumeration Date | 10/18/2013 |
| Last Update Date | 12/16/2025 |
| Medicare PECOS PAC ID | 0345135414 |
|---|---|
| Medicare Enrollment ID | O20131211001264 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033547567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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