Provider Demographics
NPI:1730331984
Name:FUTURE CARE PLAN, INC
Entity type:Organization
Organization Name:FUTURE CARE PLAN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE MIDWIFE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITHERS
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:801-733-0555
Mailing Address - Street 1:7084 S 2300 E
Mailing Address - Street 2:SUITE #110
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3968
Mailing Address - Country:US
Mailing Address - Phone:801-733-0555
Mailing Address - Fax:801-942-5897
Practice Address - Street 1:7084 S 2300 E
Practice Address - Street 2:SUITE #110
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-3968
Practice Address - Country:US
Practice Address - Phone:801-733-0555
Practice Address - Fax:801-942-5897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2244044402261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000071002Medicare PIN