Provider Demographics
NPI:1760939367
Name:UTAH VALLEY SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:UTAH VALLEY SURGERY CENTER, LLC
Other - Org Name:GROVE CREEK SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:801-772-5050
Mailing Address - Street 1:2168 WEST GROVE PARKWAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-6711
Mailing Address - Country:US
Mailing Address - Phone:435-650-5291
Mailing Address - Fax:
Practice Address - Street 1:2168 WEST GROVE PARKWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-6711
Practice Address - Country:US
Practice Address - Phone:801-772-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical