BEAR LAKE COMMUNITY HEALTH CENTER (NPI# 1336705755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336705755 |
| Entity Type | Organization |
| Organization Name | BEAR LAKE COMMUNITY HEALTH CENTER |
| Practice Address |
517 W 100 N Ste 210 Providence UT 84332-9826 |
| Practice Telephone | 4357556061 |
| Mailing Telephone | 4357556061 |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2019-05-10 |
| Authorized Official Name | LAVAL B JENSEN (CEO) |
| Authorized Official Telephone | 4357556061 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Cache Valley Community Health Center South Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285140376 | Bear Lake Community Health Center | Pharmacy | 75 Yellow Creek Rd Ste 102, Evanston, WY 82930-5205 | 2017-12-27 |
| 1922514017 | Bear Lake Community Health Center | Pharmacy | 2620 Commercial Way Ste 121, Rock Springs, WY 82901-4746 | 2017-12-27 |
| 1568732501 | Bear Lake Community Health Center | Pharmacy | 75 Yellow Creek Rd # S-102, Evanston, WY 82930-5235 | 2012-01-09 |
| 1083886865 | Bear Lake Community Health Center | Pharmacy | 1515 N 400 E, Suite 104, North Logan, UT 84341-7561 | 2008-04-01 |
| 1689754475 | Bear Lake Community Health Center | Clinic/Center | 325 W. Logan Hwy, Garden City, UT 84028-0328 | 2006-10-16 |
| 1740383884 | Bear Lake Community Health Center | Pharmacy | 325 W Logan Hwy, Garden City, UT 84028 | 2006-09-06 |
| 1063940344 | Bear Lake Community Health Center | Clinic/Center | 2620 Commercial Way, Rock Springs, WY 82901-4671 | 2017-05-31 |
| 1558806125 | Bear Lake Community Health Center | Clinic/Center | 5 W 200 N, Brigham City, UT 84302-2109 | 2017-01-05 |
| 1861949679 | Bear Lake Community Health Center | Pharmacy | 152 S 4th St, Montpelier, ID 83254-1538 | 2016-09-09 |
| 1003264664 | Bear Lake Community Health Center | Clinic/Center | 152 S 4th St, Montpelier, ID 83254-1538 | 2016-05-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEAR LAKE COMMUNITY HEALTH CENTER, INC. | 325 W Logan Hwy, Garden City, UT 84028 |
| Street Address |
517 W 100 N STE 210 |
| City | PROVIDENCE |
| State | UT |
| Zip Code | 84332-9826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292167 | 3bc Incorporated | Pharmacy | 435 North Gateway Drive #802, Providence, UT 84332 | 2020-10-09 |
| 1962049932 | Wholelife Family Wellness Clinic of Providence Pllc | Counselor | 169 N Gateway Dr. Suite 170, Providence, UT 84332 | 2019-12-09 |
| 1033503420 | Spring Creek Surgical Center, LLC | Clinic/Center | 65 North Gateway Drive, Suite 3, Providence, UT 84332 | 2015-03-24 |
| 1558751438 | Naturopathic Medical, P.C. | Naturopath | 565 W. 465 N., Suite 150, Providence, UT 84332 | 2015-01-29 |
| 1821421710 | Erin Campbell | Physical Therapist | 267 West Spring Creek Parkway, Providence, UT 84332 | 2013-08-14 |
| 1285981530 | Jordan Joseph Hansen | Dentist | 169 N Gateway Drive, Suite 200, Providence, UT 84332 | 2012-08-06 |
| 1598086720 | Cory B Maughan | Dermatology | 169 N Gateway Dr Ste 100, Providence, UT 84332 | 2010-06-22 |
| 1528299245 | South Valley Eyecare Center, Inc. | Optometrist | 276 Springcreek Pkwy, Providence, UT 84332 | 2009-07-29 |
| 1316134356 | Heather Saxton Maughan | Speech-Language Pathologist | 344 E Edgehill Dr, Providence, UT 84332 | 2007-10-03 |
| 1902021538 | Brad L Thomas | Physical Therapist | 169 Spring Creek Park Way, Suite 140, Providnce, UT 84332 | 2007-04-17 |
| Find all providers in zip 84332 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292167 | 3bc Incorporated | Pharmacy | 435 North Gateway Drive #802, Providence, UT 84332 | 2020-10-09 |
| 1568949683 | Allcare Rx Solutions LLC | Pharmacy | 265 Waterman St, Providence, RI 02906-5127 | 2018-07-21 |
| 1952854903 | Rite Aid Pharmacy | Pharmacy | 412 Angell St, Apartment 2, Providence, RI 02906-4013 | 2016-07-26 |
| 1750564514 | South Valley Pharmacy | Pharmacy | 1652 S Highway 165, Providence, UT 84332-6701 | 2007-12-14 |
| 1518153014 | Ccr Pharmacy LLC | Pharmacy | 1017 Smith St, Providence, RI 02908-2747 | 2007-09-18 |
| 1558495457 | Maceys Inc | Pharmacy | 50 North Highway 165, Providence, UT 84332 | 2007-03-15 |
| 1679621676 | Prime Drug Inc | Pharmacy | 613 Cranston St, Providence, RI 02907-2813 | 2007-01-08 |
| 1528144128 | Genter's Pharmacy Corp | Pharmacy | 866 Broad St, Providence, RI 02907-1724 | 2006-10-27 |
| 1093819898 | Rhode Island Cvs Pharmacy, L.L.C. | Pharmacy | 960 Broad St, Providence, RI 02905-1822 | 2006-09-12 |
| 1003910803 | Rhode Island Cvs Pharmacy, L.L.C. | Pharmacy | 481 Angell St, Providence, RI 02906-4407 | 2006-09-12 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 84332 |
Please comment or provide details below to improve the information on BEAR LAKE COMMUNITY HEALTH CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.