Provider Demographics
NPI:1073988077
Name:SOUTHWEST UTAH COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:SOUTHWEST UTAH COMMUNITY HEALTH CENTER
Other - Org Name:D/B/A FAMILY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-879-5101
Mailing Address - Street 1:2276 E RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2636
Mailing Address - Country:US
Mailing Address - Phone:435-986-2565
Mailing Address - Fax:435-986-2577
Practice Address - Street 1:245 EAST 680 SOUTH
Practice Address - Street 2:FAMILY HEALTHCARE CENTER EAST CLINIC
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720
Practice Address - Country:US
Practice Address - Phone:435-865-1387
Practice Address - Fax:435-865-6357
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST UTAH CUMMUNITY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-02
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT461846OtherUGS