Provider Demographics
NPI:1235546797
Name:5 MINUTE CLINIC
Entity Type:Organization
Organization Name:5 MINUTE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:
Authorized Official - Last Name:SISNEROS
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:435-654-1377
Mailing Address - Street 1:150 N MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-1670
Mailing Address - Country:US
Mailing Address - Phone:435-654-1377
Mailing Address - Fax:
Practice Address - Street 1:150 N MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-1670
Practice Address - Country:US
Practice Address - Phone:435-654-1377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3140981206261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care