Provider Demographics
NPI:1801040357
Name:REPRODUCTIVE CARE CENTER
Entity Type:Organization
Organization Name:REPRODUCTIVE CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-878-8888
Mailing Address - Street 1:10150 PETUNIA WAY
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-4380
Mailing Address - Country:US
Mailing Address - Phone:801-878-8888
Mailing Address - Fax:801-878-8890
Practice Address - Street 1:10150 PETUNIA WAY
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-4380
Practice Address - Country:US
Practice Address - Phone:801-878-8888
Practice Address - Fax:801-878-8890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty