| Revere Health | |
|
3000 N Triumph Blvd Ste 100 Lehi UT 84043-4999 | |
| (801) 429-8000 | |
| Not Available |
| Full Name | Revere Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 3000 N Triumph Blvd Ste 100, Lehi, Utah |
| Authorized Official Name and Position | Jed Harston (DIRECTOR OF MANAGED CARE) |
| Authorized Official Contact | 8018125012 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revere Health 1055 N 500 W Attn: Credentialing Provo UT 84604-3305 Ph: (801) 354-8225 | Revere Health 3000 N Triumph Blvd Ste 100 Lehi UT 84043-4999 Ph: (801) 429-8000 |
| NPI Number | 1023251204 |
|---|---|
| Provider Enumeration Date | 04/17/2009 |
| Last Update Date | 01/13/2020 |
| Medicare PECOS PAC ID | 7517868508 |
|---|---|
| Medicare Enrollment ID | O20100930081283 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023251204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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