Provider Demographics
NPI:1962413690
Name:SOUTHWEST UTAH PUBLIC HEALTH DEPARTMENT
Entity type:Organization
Organization Name:SOUTHWEST UTAH PUBLIC HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:H
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:435-586-2437
Mailing Address - Street 1:260 DL SARGENT DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-9342
Mailing Address - Country:US
Mailing Address - Phone:435-586-2437
Mailing Address - Fax:435-586-4851
Practice Address - Street 1:260 DL SARGENT DR
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-9342
Practice Address - Country:US
Practice Address - Phone:435-586-2437
Practice Address - Fax:435-586-4851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5244642-3101251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare