Evergreen Clinic Llc

LBN: Evergreen Clinic Llc
Evergreen Clinic Llc is an health care organization with primary practice located at 1561 W 7000 S Ste 100 , West Jordan UT 84084-3556. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Evergreen Clinic Llc can be contacted via phone (801) 850-1958, or through Gonzalez, Ignacio Nicolas via phone (801) 850-1958.

Contact Information

Primary practice address
1561 W 7000 S Ste 100 West Jordan UT 84084-3556
Phone: (801) 850-1958
Fax: (801) 747-6881
Website:
Map and Directions
Authorized official contact:
Name: Gonzalez, Ignacio Nicolas
Phone: (801) 850-1958

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1689210551
LBN Legal business name Evergreen Clinic Llc
DBA Doing business as
Authorized official Gonzalez, Ignacio Nicolas
Entity Organization
Organization subpart 1 No
Enumeration date Nov 25th, 2019
Last updated Jan 13th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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