Healthcare Provider Details

I. General information

NPI: 1548588247
Provider Name (Legal Business Name): SOUTHWEST UTAH COMMUNITY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2010
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 W. HARDING AVE
CEDAR CITY UT
84720
US

IV. Provider business mailing address

2276 E RIVERSIDE DR
ST GEORGE UT
84790-2636
US

V. Phone/Fax

Practice location:
  • Phone: 435-986-2565
  • Fax:
Mailing address:
  • Phone: 435-986-2565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number49217390140
License Number StateUT

VIII. Authorized Official

Name: MS. LORRIANE WRIGHT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 435-879-5101