Organization
BEAR LAKE COMMUNITY HEALTH CENTER, INC.
Active
Other names
Bear Lake Community Health Center - Randolph
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE GARCIA (CEO)
(435) 755-6061
Entity
Organization
Contact information
Practice address
120 S MAIN ST, RANDOLPH, UT 84064-7701
(435) 755-6061
Mailing address
517 W 100 N STE 210, PROVIDENCE, UT 84332-9826
(435) 755-6061
(435) 994-8362
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
06/08/2021
Last updated
04/27/2022
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