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CH08395D MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC (Active)
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Main Details
Name
MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC
Subdivision Name
Mountainlands Family Health Center Vernal Dental Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013946
340B ID
CH08395D
Grant Number
H80CS00213
Additional Details
Current Program Status
Active
Registration Date
10/1/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/20/2015
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
Mountainlands Community Health Center, Inc.
Todd Bailey, Executive Director
(801) 429-2000 Ext: 1155
Primary Contact
Mountainlands Community Health Center
Ronda Yorgason, Director of Operations
(801) 855-0153
Addresses
Street Address
133 S 500 E
VERNAL, UT 84078-2728
Billing Address
Mountainlands Community Health Center
589 S. State Street
Provo, UT 84606
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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