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Organization
CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION
Active
Organization
CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA THATCHER (BILLING)
(801) 359-2256
Entity
Organization
Contact information
Practice address
660 S 200 E STE 250, SALT LAKE CITY, UT 84111-3846
(801) 359-2256
Mailing address
660 S 200 E, SUITE 250, SALT LAKE CITY, UT 84111-3835
(801) 359-2256
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
8547079-1704
UT
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140406
PK
—
Enumeration date
05/09/2013
Last updated
12/11/2025
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