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NPI Code Detail

MEDICARE: HILLTOP MEDICAL CLINIC, LLC

MEDICARE: HILLTOP MEDICAL CLINIC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3103TA0400XAddiction (Substance Use Disorder) Psychologist

General Provider Information

NPI Number : 1255860250
Entity Type Code : Organization
Provider Name (Legal Business Name) : HILLTOP MEDICAL CLINIC, LLC
Provider Business Mailing Address
First Line : 2450 E FORT UNION BLVD
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-3337
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2450 E FORT UNION BLVD
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-3337
Country : US
Telephone Number : 801-669-5888
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF ADMINISTRATION
Name : ERIC SCHMIDT
Credential :
Telephone Number : 801-669-5888
Provider Enumeration Date : 06/05/2017
Last Update Date : 06/05/2017

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Directions to “HILLTOP MEDICAL CLINIC, LLC ” Practice Location

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