NPI Lookup
NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

72ND STREET CLINIC
LBN COMMUNITY HEALTH CENTERS INC.
220 W 7200 S
SUITE A
MIDVALE, UT84047-1043
 Phone: 801-566-5494
 Fax: 801-561-9647
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Multi-Specialty

261QM1300X 70 Clinic or Group Practice
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for 72ND STREET CLINIC

NPI Number 1073611364
LBN Legal business name COMMUNITY HEALTH CENTERS INC.
DBA Doing business as 72ND STREET CLINIC
Authorized official DEXTER PEARCE - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/20/2006
Last updated 07/26/2016 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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