| Northwestern Band Of The Shoshone | |
|
984 S 500 W Ste 3 Brigham City UT 84302-4712 | |
| (435) 239-8524 | |
| Not Available |
| Full Name | Northwestern Band Of The Shoshone |
|---|---|
| Speciality | General Practice |
| Location | 984 S 500 W Ste 3, Brigham City, Utah |
| Authorized Official Name and Position | Hunter Timbimboo (DIRECTOR OF HEALTH & HUMAN SERVICES) |
| Authorized Official Contact | 4352378066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwestern Band Of The Shoshone 707 N Main St Brigham City UT 84302-1449 Ph: (435) 734-2286 | Northwestern Band Of The Shoshone 984 S 500 W Ste 3 Brigham City UT 84302-4712 Ph: (435) 239-8524 |
| NPI Number | 1841856986 |
|---|---|
| Provider Enumeration Date | 05/14/2019 |
| Last Update Date | 03/22/2021 |
| Medicare PECOS PAC ID | 4981011145 |
|---|---|
| Medicare Enrollment ID | O20210406000915 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841856986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Susan Beryl Harp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508912643 PECOS PAC ID: 8729160775 Enrollment ID: I20210406001308 |
Brigham Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1050 South Medical Drive, Suite 101, Brigham City, UT 84302 Phone: 435-538-1733 Fax: 435-538-1752 | |
Community Health Centers, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 980 S 500 W Ste 1, Brigham City, UT 84302 Phone: 435-723-8276 Fax: 877-497-4661 | |
Mountain Top Medical, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 140 E 1000 S Ste B2, Brigham City, UT 84302 Phone: 435-515-3030 Fax: 435-515-3434 | |
Access Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 W 200 N, Brigham City, UT 84302 Phone: 435-723-7999 Fax: 435-723-7331 | |
Health West, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5 W 200 N, Brigham City, UT 84302 Phone: 435-723-7999 | |
Perry Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1030 Medical Dr, Suite A, Brigham City, UT 84302 Phone: 435-723-4500 Fax: 435-723-4504 | |
Bear Lake Community Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 W 200 N, Brigham City, UT 84302 Phone: 435-723-7999 Fax: 435-723-7331 |