MEDICARE: FUTURE CARE PLAN, INC

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	261QP2300X	Primary Care Clinic/Center	2244044402	UT

General Provider Information

NPI Number	:	1730331984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUTURE CARE PLAN, INC

Provider Business Mailing Address
First Line	:	7084 S 2300 E
Second Line	:	SUITE #110
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3968
Country	:	US
Telephone Number	:	801-733-0555
Fax Number	:	801-942-5897

Provider Business Practice Location Address
First Line	:	7084 S 2300 E
Second Line	:	SUITE #110
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3968
Country	:	US
Telephone Number	:	801-733-0555
Fax Number	:	801-942-5897

Authorized Official
Title or Position	:	CERTIFIED NURSE MIDWIFE
Name	:	MRS. JACQUELINE SMITHERS
Credential	:	CNM
Telephone Number	:	801-733-0555

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	10/24/2008

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