| Revere Health | |
|
736 S 900 E Ste 203 St George UT 84790-7003 | |
| (435) 673-6131 | |
| (435) 673-8557 |
| Full Name | Revere Health |
|---|---|
| Speciality | Family Medicine |
| Location | 736 S 900 E Ste 203, St George, Utah |
| Authorized Official Name and Position | Jed Harston (DIRECTOR OF MANAGED CARE) |
| Authorized Official Contact | 8018125012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revere Health 1055 N 500 W Attn: Credentialing Provo UT 84604-3305 Ph: (801) 354-8225 | Revere Health 736 S 900 E Ste 203 St George UT 84790-7003 Ph: (435) 673-6131 |
| NPI Number | 1295829281 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 03/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295829281 | NPI | - | NPPES |
| 46D0525920 | Other | UT | CLIA NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Utah) | Primary |
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