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CH082480 ENTERPRISE VALLEY MEDICAL CLINIC (Active)
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Main Details
Name
ENTERPRISE VALLEY MEDICAL CLINIC
Subdivision Name
ENTERPRISE VALLEY MED CLINIC, INC.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003242
340B ID
CH082480
Grant Number
H80CS00644
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
6/25/2004
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Enterprise Valley Medical Clinic
RYDEL REBER, EXECUTIVE DIRECTOR
(435) 878-2281
Primary Contact
Enterprise Valley Medical Clinic
Raean Banks, Office Manager
(435) 878-2281
Addresses
Street Address
223 SOUTH 200 EAST
ENTERPRISE, UT 84725-0370
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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