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FP004219 PLANNED PARENTHOOD ASSOC. OF UTAH (Active)
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Main Details
Name
PLANNED PARENTHOOD ASSOC. OF UTAH
Subdivision Name
WEST VALLEY CLINIC
Type
Family Planning (Title X only)
340B ID
FP004219
Grant Number
FPHPA006544
Additional Details
Current Program Status
Active
Registration Date
7/26/2022
Participating Start Date
10/1/2022
Participating Approval Date
7/29/2022
Last Recertification Date
5/9/2025
Contacts
Authorizing Official
Planned Parenthood Association of UTAH
Lori Gawron, Chief Medical Officer / Surgical Director
(312) 560-6162
Primary Contact
Planned Parenthood Association of Utah
Carol Paglis, PIC
(801) 532-1586
Addresses
Street Address
1906 WEST 3600 SOUTH
WEST VALLEY CITY, UT 84119
Billing Address
PLANNED PARENTHOOD ASSOC. OF UTAH
654 SOUTH 900 EAST
SALT LAKE CITY, UT 84102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date: (1/1/1998) until terminated date: (10/1/2019), reinstatement effective date: (10/1/2022)
07/28/2022
2/16/10 ADDED MEDICIAD #; 12/14/03 UPDATED ADDR(WAS 2107 WEST 3500 SOUTH); 12/14/03 ADDED BILL TO; 12/14/03 UPDATED MEDICAID #(WAS 870288909019)
02/16/2010
May 2025
May 2025
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