Healthcare Provider Details

I. General information

NPI: 1093834038
Provider Name (Legal Business Name): MOUNTAIN MEDICAL URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 EAST MAIN STREET SUITE E
LEHI UT
84043
US

IV. Provider business mailing address

1311 E WILLOW SPRINGS CIR
ALPINE UT
84004-1790
US

V. Phone/Fax

Practice location:
  • Phone: 801-768-1555
  • Fax: 801-768-1569
Mailing address:
  • Phone: 801-756-6086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN R. PACK
Title or Position: OWNER
Credential: M.D.
Phone: 801-768-1555