MEDICARE: CONCEPTIONS FAMILY BUILDING ASSOCIATES, PLLC

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
1	261QF0050X	Non-Surgical Family Planning Clinic/Center
2	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1649745506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCEPTIONS FAMILY BUILDING ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	2435 W 450 S STE 103
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-3163
Country	:	US
Telephone Number	:	801-889-5559
Fax Number	:

Provider Business Practice Location Address
First Line	:	2435 W 450 S STE 103
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-3163
Country	:	US
Telephone Number	:	801-889-5559
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREW MOORE
Credential	:	MD
Telephone Number	:	801-889-5559

Provider Enumeration Date	:	10/08/2018
Last Update Date	:	10/25/2018

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