| Shivwits Medical Clinic | |
|
1449 N 1400 W Ste 19 St George UT 84770-5237 | |
| (354) 688-8199 | |
| (435) 688-7572 |
| Full Name | Shivwits Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1449 N 1400 W Ste 19, St George, Utah |
| Authorized Official Name and Position | Tyler Prisbrey (CFO) |
| Authorized Official Contact | 4355861112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shivwits Medical Clinic 440 N Paiute Dr Cedar City UT 84720-2681 Ph: (435) 586-1112 | Shivwits Medical Clinic 1449 N 1400 W Ste 19 St George UT 84770-5237 Ph: (354) 688-8199 |
| NPI Number | 1801063441 |
|---|---|
| Provider Enumeration Date | 05/13/2008 |
| Last Update Date | 02/13/2024 |
| Medicare PECOS PAC ID | 3072414952 |
|---|---|
| Medicare Enrollment ID | O20150803002263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801063441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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