Provider Demographics
NPI:1083076665
Name:ONSITE CARE CLINICS
Entity Type:Organization
Organization Name:ONSITE CARE CLINICS
Other - Org Name:SCOPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LATSIS
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:801-441-1002
Mailing Address - Street 1:10000 S CENTENNIAL PKWY
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-4148
Mailing Address - Country:US
Mailing Address - Phone:801-568-4664
Mailing Address - Fax:
Practice Address - Street 1:10000 S CENTENNIAL PKWY
Practice Address - Street 2:SUITE 235
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-4148
Practice Address - Country:US
Practice Address - Phone:801-568-4664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT129931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty