Provider Demographics
NPI:1699377358
Name:VERTEX PRIMARY CARE LLC
Entity Type:Organization
Organization Name:VERTEX PRIMARY CARE LLC
Other - Org Name:VASECTOMY PRO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KINDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-210-0659
Mailing Address - Street 1:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-7810
Mailing Address - Country:US
Mailing Address - Phone:385-200-1097
Mailing Address - Fax:
Practice Address - Street 1:11760 S 700 E STE 112
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-6605
Practice Address - Country:US
Practice Address - Phone:385-200-1097
Practice Address - Fax:385-351-9453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care