Provider Demographics
NPI:1851921993
Name:ASPEN CONSOLIDATED HEALTH LLC
Entity Type:Organization
Organization Name:ASPEN CONSOLIDATED HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF HEALTHCARE
Authorized Official - Prefix:
Authorized Official - First Name:BRANNICK
Authorized Official - Middle Name:BARTON
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:385-440-1400
Mailing Address - Street 1:360 S 1300 W
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-3761
Mailing Address - Country:US
Mailing Address - Phone:385-440-1400
Mailing Address - Fax:801-845-9965
Practice Address - Street 1:360 S 1300 W
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-3761
Practice Address - Country:US
Practice Address - Phone:385-440-1400
Practice Address - Fax:801-845-9965
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPEN CONSOLIDATED HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty