MEDICARE: PLANNED PARENTHOOD ASSOCIATION OF UTAH

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	3336C0002X	Clinic Pharmacy	58748591704	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2144679	OTHER		PK

General Provider Information

NPI Number	:	1881010874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD ASSOCIATION OF UTAH

Provider Business Mailing Address
First Line	:	654 S 900 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-3478
Country	:	US
Telephone Number	:	801-532-1586
Fax Number	:	801-532-5748

Provider Business Practice Location Address
First Line	:	1906 W 3600 S
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-4715
Country	:	US
Telephone Number	:	801-973-9675
Fax Number	:	801-973-0379

Authorized Official
Title or Position	:	VP CLINICAL PROGRAMS
Name	:	PENNY DAVIES
Credential	:
Telephone Number	:	801-532-1586

Provider Enumeration Date	:	03/14/2014
Last Update Date	:	09/16/2021

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Directions to “PLANNED PARENTHOOD ASSOCIATION OF UTAH ” Practice Location

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