Healthcare Provider Details

I. General information

NPI: 1285125120
Provider Name (Legal Business Name): PLANNED PARENTHOOD ASSOCIATION OF UTAH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2018
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 S BLUFF ST STE 1
ST GEORGE UT
84770-3593
US

IV. Provider business mailing address

654 S 900 E
SALT LAKE CITY UT
84102-3478
US

V. Phone/Fax

Practice location:
  • Phone: 435-674-9933
  • Fax:
Mailing address:
  • Phone: 801-532-1586
  • Fax: 801-532-5748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number9708980-1704
License Number StateUT

VIII. Authorized Official

Name: LESLEY BAILEY
Title or Position: CFO
Credential:
Phone: 801-532-1586