NPI 1629309786 · live from the CMS NPI Registry
Bear Lake Community Health Center, INC.
Family Medicine in Garden City, UT. National Provider Identifier 1629309786, active.
NPI record
| NPI | 1629309786 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 325 West Logan Highway, Garden City, UT 84028 |
| Practice phone | 435-946-3660 |
| Mailing address | 517 W 100 N Ste 210, Providence, UT 84332 |
| Enumerated | January 28, 2010 |
| Last updated | June 6, 2022 |
| Authorized official | Jorge Garcia, Ceo |
| Other names | Bear Lake Community Health Center; Rock Springs Community Health Center; Cache Valley Community Health Center; Evanston Community Health Center; Box Elder Community Health Center; Cache Valley Community Health Center- Providence; Bear Lake Community Health Center- Montpelier; Bear Lake Community Health Center- Randolph |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker | 104100000X | — |
| Marriage & Family Therapist | 106H00000X | — |
| Dentist | 122300000X | — |
| Dentist, General Practice | 1223G0001X | — |
| Dietitian, Registered | 133V00000X | — |
| Optometrist | 152W00000X | — |
| Pharmacist, Psychiatric | 1835P1300X | — |
| Obstetrics & Gynecology | 207V00000X | — |
| Psychiatry & Neurology, Child & Adolescent Psychiatry | 2084P0804X | — |
| Physician Assistant | 363A00000X | — |
| Nurse Practitioner | 363L00000X | — |
| Nurse Practitioner, Family | 363LF0000X | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — |
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.