Provider Demographics
NPI:1568411437
Name:CEDAR CITY INSTACARE
Entity Type:Organization
Organization Name:CEDAR CITY INSTACARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-632-5398
Mailing Address - Street 1:962 SAGE DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-1885
Mailing Address - Country:US
Mailing Address - Phone:435-868-5521
Mailing Address - Fax:435-868-5504
Practice Address - Street 1:962 SAGE DR
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-1885
Practice Address - Country:US
Practice Address - Phone:435-868-5521
Practice Address - Fax:435-868-5504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care