Provider Demographics
NPI:1851917496
Name:CENTRE HEALTH GROUP
Entity Type:Organization
Organization Name:CENTRE HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABBEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-717-5395
Mailing Address - Street 1:933 E 1910 S STE 102
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-5562
Mailing Address - Country:US
Mailing Address - Phone:801-882-2799
Mailing Address - Fax:888-908-0805
Practice Address - Street 1:933 E 1910 S STE 102
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-5562
Practice Address - Country:US
Practice Address - Phone:801-882-2799
Practice Address - Fax:888-908-0805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-19
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care