Organization
BEAR LAKE COMMUNITY HEALTH CENTER PHARMACY
Active
Organization
BEAR LAKE COMMUNITY HEALTH CENTER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
D.J. BALLINGHAM PA-C (MEDICAL DIRECTOR)
(435) 946-3660
Entity
Organization
Contact information
Practice address
325 WEST LOGAN HWY., GARDEN CITY, UT 84028
(435) 946-2770
(435) 946-2781
Mailing address
325 WEST LOGAN HWY., P. O. BOX 328, GARDEN CITY, UT 84028
(435) 946-2770
(435) 946-2781
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
UT
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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