Organization
CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION
Active
Other names
Sacred Circle Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARISSA SORENSEN MONROY MD (MEDICAL OFFICER)
(801) 359-2256
Entity
Organization
Contact information
Practice address
3535 S MARKET ST STE 200, WEST VALLEY CITY, UT 84119-3685
(801) 359-2256
Mailing address
660 S 200 E STE 250, SALT LAKE CITY, UT 84111-3846
(801) 391-0563
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
12/19/2024
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