Provider Demographics
NPI:1801081153
Name:PIERCE HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:PIERCE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:C
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:435-781-8738
Mailing Address - Street 1:975 W HIGHWAY 40
Mailing Address - Street 2:STE 1
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2400
Mailing Address - Country:US
Mailing Address - Phone:435-781-8738
Mailing Address - Fax:
Practice Address - Street 1:975 W HIGHWAY 40
Practice Address - Street 2:STE 1
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2400
Practice Address - Country:US
Practice Address - Phone:435-781-8738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT129344-1202305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization