Provider Demographics
NPI:1811351505
Name:ADVANCED CLINICAL RESEARCH, INC.
Entity type:Organization
Organization Name:ADVANCED CLINICAL RESEARCH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-542-8190
Mailing Address - Street 1:3590 W 9000 S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-8857
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3590 W 9000 S
Practice Address - Street 2:SUITE 300
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-8857
Practice Address - Country:US
Practice Address - Phone:801-542-8190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center