Provider Demographics
NPI:1972327971
Name:FIRST CARE MEDICAL-FAMILY MEDICINE, LLC
Entity type:Organization
Organization Name:FIRST CARE MEDICAL-FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NATE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-899-2053
Mailing Address - Street 1:2168 W GROVE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-6748
Mailing Address - Country:US
Mailing Address - Phone:801-899-2053
Mailing Address - Fax:
Practice Address - Street 1:1640 W 500 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84104-5202
Practice Address - Country:US
Practice Address - Phone:801-886-0930
Practice Address - Fax:801-886-0956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty