| Mountain Ridge Healthcare Pllc | |
|
2135 W Main St Ste B105 Lehi UT 84043-6936 | |
| (801) 663-1296 | |
| Not Available |
| Full Name | Mountain Ridge Healthcare Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2135 W Main St Ste B105, Lehi, Utah |
| Authorized Official Name and Position | Chad Lloyd Roberts (PHYSICIAN / BUSINESS OWNER) |
| Authorized Official Contact | 8016631296 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Ridge Healthcare Pllc 174 S 600 E Alpine UT 84004-1724 Ph: (801) 663-1296 | Mountain Ridge Healthcare Pllc 2135 W Main St Ste B105 Lehi UT 84043-6936 Ph: (801) 663-1296 |
| NPI Number | 1710695473 |
|---|---|
| Provider Enumeration Date | 11/11/2022 |
| Last Update Date | 11/15/2022 |
| Medicare PECOS PAC ID | 9739559873 |
|---|---|
| Medicare Enrollment ID | O20230105001725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710695473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Chad Lloyd Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952964330 PECOS PAC ID: 6406180603 Enrollment ID: I20220829003424 |
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