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Healthy Premier - Individual & Family Table of Contents

GENERAL INFORMATION ..................................................................................................................................................... 6

WELCOME ........................................................................................................................................................................... 7

BIENVENIDOS .................................................................................................................................................................... 10

UNIVERSITY OF UTAH HEALTH PLANS CONTRACTING CRITERIA ......................................................................................... 12

PARTICIPATING FACILITIES & ANCILLARY SERVICES ........................................................................................................... 13

HOSPITALS ................................................................................................................................................................................ 13 HOSPITALS, LONG TERM ACUTE CARE (LTAC) ................................................................................................................................. 13 HOSPITALS, PSYCHIATRIC ............................................................................................................................................................. 14 URGENT CARE CENTERS ............................................................................................................................................................... 14 AMBULANCE SERVICES ................................................................................................................................................................ 16 PUBLIC HEALTH CENTERS / CLINICS ................................................................................................................................................ 16 RURAL HEALTH CLINICS ............................................................................................................................................................... 16 ADDICTION TREATMENT .............................................................................................................................................................. 16 AMBULATORY BEHAVIORAL HEALTH CLINICS .................................................................................................................................... 16 AMBULATORY SURGERY CENTERS .................................................................................................................................................. 16 CARDIAC MONITORING ............................................................................................................................................................... 17 DIABETES EDUCATION CENTERS .................................................................................................................................................... 17 DIABETES SUPPLY CENTERS .......................................................................................................................................................... 18 DIALYSIS CENTERS ...................................................................................................................................................................... 18 HEARING CENTERS ...................................................................................................................................................................... 19 HOME HEALTH AGENCIES ............................................................................................................................................................ 19 HOME INFUSION SERVICES ........................................................................................................................................................... 22 HOME MEDICAL SUPPLIES / DURABLE MEDICAL EQUIPMENT (DME) ................................................................................................... 22 HOSPICE CARE ........................................................................................................................................................................... 25 INFUSION SUITES ........................................................................................................................................................................ 27 LABORATORY / PATHOLOGY ......................................................................................................................................................... 27 LABORATORY DRAW STATIONS ..................................................................................................................................................... 28 LANGUAGE INTERPRETER SERVICES ................................................................................................................................................ 29 MAMMOGRAPHY SCREENING CENTERS ........................................................................................................................................... 29 RADIOLOGY / IMAGING CENTERS ................................................................................................................................................... 30 REHABILITATION SERVICES............................................................................................................................................................ 31 RESIDENTIAL MENTAL HEALTH FACILITIES ....................................................................................................................................... 31 SKILLED NURSING FACILITIES ......................................................................................................................................................... 31 SLEEP STUDY LABS ...................................................................................................................................................................... 33 VISION CENTERS (OPTICAL SUPPLIERS) ........................................................................................................................................... 33

PARTICIPATING PRIMARY CARE PROVIDERS ...................................................................................................................... 35

ADOLESCENT MEDICINE ............................................................................................................................................................... 35 FAMILY MEDICINE ...................................................................................................................................................................... 35 GENERAL PRACTICE ..................................................................................................................................................................... 74 GERIATRIC MEDICINE .................................................................................................................................................................. 75 HEALTH CENTER/CLINIC .............................................................................................................................................................. 76 INTERNAL MEDICINE ................................................................................................................................................................... 78 MULTISPECIALTY CLINIC ............................................................................................................................................................... 96 OBSTETRICS AND GYNECOLOGY ................................................................................................................................................... 142 PEDIATRICS ............................................................................................................................................................................. 161 PREVENTIVE MEDICINE .............................................................................................................................................................. 186


PARTICIPATING SPECIALTY PROVIDERS ........................................................................................................................... 187

ADDICTION MEDICINE ............................................................................................................................................................... 187 ADVANCED HEART FAILURE AND TRANSPLANT CARDIOLOGY ............................................................................................................. 187 ALLERGY AND IMMUNOLOGY ...................................................................................................................................................... 188 AUDIOLOGY............................................................................................................................................................................. 190 BRAIN INJURY MEDICINE ............................................................................................................................................................ 196 CARDIAC ELECTROPHYSIOLOGY, CLINICAL ...................................................................................................................................... 196 CARDIOLOGY, INTERVENTIONAL................................................................................................................................................... 199 CARDIOTHORACIC SURGERY ........................................................................................................................................................ 201 CARDIOVASCULAR DISEASE ......................................................................................................................................................... 204 CHILD ABUSE PEDIATRICS ........................................................................................................................................................... 213 CHIROPRACTIC ......................................................................................................................................................................... 213 CLINICAL INFORMATICS .............................................................................................................................................................. 218 CLINICAL LIPIDOLOGY ................................................................................................................................................................ 218 COLON AND RECTAL SURGERY .................................................................................................................................................... 218 DERMATOLOGY ........................................................................................................................................................................ 219 DIABETES EDUCATION ............................................................................................................................................................... 227 ELECTRODIAGNOSTIC MEDICINE .................................................................................................................................................. 227 ENDOCRINOLOGY, DIABETES AND METABOLISM ............................................................................................................................. 228 FAMILY MEDICINE .................................................................................................................................................................... 230 FEMALE PELVIC MEDICINE AND RECONSTRUCTIVE SURGERY ............................................................................................................. 231 FOOT AND ANKLE SURGERY ........................................................................................................................................................ 231 GASTROENTEROLOGY ................................................................................................................................................................ 232 GENERAL PRACTICE ................................................................................................................................................................... 238 GENETIC COUNSELING ............................................................................................................................................................... 238 GENETICS AND GENOMICS, CLINICAL ............................................................................................................................................ 239 HAND SURGERY ....................................................................................................................................................................... 240 HEALTH CENTER/CLINIC ............................................................................................................................................................ 241 HEMATOLOGY.......................................................................................................................................................................... 241 HEMATOLOGY/ONCOLOGY......................................................................................................................................................... 243 HOSPICE AND PALLIATIVE MEDICINE ............................................................................................................................................ 247 INFECTIOUS DISEASE ................................................................................................................................................................. 248 INTERNAL MEDICINE ................................................................................................................................................................. 249 MATERNAL AND FETAL MEDICINE ................................................................................................................................................ 255 MIDWIFERY ............................................................................................................................................................................. 258 MULTISPECIALTY CLINIC ............................................................................................................................................................. 258 NEPHROLOGY .......................................................................................................................................................................... 260 NEURODEVELOPMENTAL DISABILITIES........................................................................................................................................... 269 NEUROLOGICAL SURGERY........................................................................................................................................................... 270 NEUROLOGY ............................................................................................................................................................................ 273 NEUROLOGY WITH SPECIAL QUALIFICATION IN CHILD NEUROLOGY ..................................................................................................... 278 NEUROMUSCULAR MEDICINE ..................................................................................................................................................... 279 NEUROPHYSIOLOGY, CLINICAL ..................................................................................................................................................... 279 NEUROTOLOGY ........................................................................................................................................................................ 280 NUCLEAR CARDIOLOGY .............................................................................................................................................................. 280 NURSE PRACTITIONER ............................................................................................................................................................... 281 NURSE PRACTITIONER, FAMILY ................................................................................................................................................... 281 NURSE PRACTITIONER, PSYCHIATRIC-MENTAL HEALTH .................................................................................................................... 282 NURSE PRACTITIONER, WOMEN'S HEALTH .................................................................................................................................... 282


OBSTETRICS AND GYNECOLOGY ................................................................................................................................................... 282 OCCUPATIONAL MEDICINE ......................................................................................................................................................... 283 OCCUPATIONAL THERAPY ........................................................................................................................................................... 284 ONCOLOGY, GYNECOLOGIC ........................................................................................................................................................ 290 ONCOLOGY, MEDICAL ............................................................................................................................................................... 291 OPHTHALMOLOGY .................................................................................................................................................................... 294 OPTOMETRY ............................................................................................................................................................................ 305 ORAL AND MAXILLOFACIAL SURGERY ........................................................................................................................................... 313 ORTHOPAEDIC SPORTS MEDICINE ................................................................................................................................................ 316 ORTHOPEDICS/ORTHOPAEDIC SURGERY........................................................................................................................................ 317 OTOLARYNGOLOGY (ENT) ......................................................................................................................................................... 331 PAIN MEDICINE ....................................................................................................................................................................... 339 PEDIATRIC CARDIOLOGY............................................................................................................................................................. 346 PEDIATRIC DERMATOLOGY ......................................................................................................................................................... 351 PEDIATRIC ENDOCRINOLOGY ....................................................................................................................................................... 351 PEDIATRIC GASTROENTEROLOGY ................................................................................................................................................. 353 PEDIATRIC HEMATOLOGY-ONCOLOGY .......................................................................................................................................... 354 PEDIATRIC INFECTIOUS DISEASES ................................................................................................................................................. 355 PEDIATRIC NEPHROLOGY ........................................................................................................................................................... 356 PEDIATRIC OTOLARYNGOLOGY .................................................................................................................................................... 356 PEDIATRIC PULMONOLOGY ......................................................................................................................................................... 357 PEDIATRIC REHABILITATION MEDICINE ......................................................................................................................................... 358 PEDIATRIC RHEUMATOLOGY ....................................................................................................................................................... 358 PEDIATRIC SLEEP MEDICINE ........................................................................................................................................................ 359 PEDIATRIC SPORTS MEDICINE ..................................................................................................................................................... 359 PEDIATRIC SURGERY .................................................................................................................................................................. 359 PEDIATRIC UROLOGY ................................................................................................................................................................. 361 PEDIATRICS ............................................................................................................................................................................. 362 PEDIATRICS, DEVELOPMENTAL-BEHAVIORAL .................................................................................................................................. 364 PHLEBOLOGY ........................................................................................................................................................................... 365 PHYSICAL MEDICINE AND REHABILITATION .................................................................................................................................... 365 PHYSICAL THERAPY ................................................................................................................................................................... 368 PHYSICAL THERAPY, CLINICAL ELECTROPHYSIOLOGY ........................................................................................................................ 399 PHYSICAL THERAPY, ORTHOPAEDICS ............................................................................................................................................ 399 PLASTIC SURGERY ..................................................................................................................................................................... 399 PLASTIC SURGERY WITHIN THE HEAD AND NECK ............................................................................................................................ 402 PODIATRY ............................................................................................................................................................................... 403 PREVENTIVE MEDICINE .............................................................................................................................................................. 408 PULMONARY DISEASE................................................................................................................................................................ 408 RADIATION ONCOLOGY ............................................................................................................................................................. 411 RADIOLOGY, INTERVENTIONAL AND DIAGNOSTIC ............................................................................................................................ 413 RADIOLOGY, VASCULAR AND INTERVENTIONAL ............................................................................................................................... 413 REGISTERED DIETITIAN/NUTRITION PROFESSIONAL ......................................................................................................................... 413 REPRODUCTIVE ENDOCRINOLOGY/INFERTILITY ............................................................................................................................... 415 RHEUMATOLOGY ...................................................................................................................................................................... 416 SLEEP MEDICINE ...................................................................................................................................................................... 418 SPEECH-LANGUAGE PATHOLOGY ................................................................................................................................................. 419 SPINAL CORD INJURY MEDICINE .................................................................................................................................................. 424 SPORTS MEDICINE .................................................................................................................................................................... 424


SURGERY, GENERAL .................................................................................................................................................................. 427 UROLOGY ............................................................................................................................................................................... 434 VASCULAR NEUROLOGY ............................................................................................................................................................. 439 VASCULAR SURGERY ................................................................................................................................................................. 439 WOUND CARE/HYPERBARIC MEDICINE ........................................................................................................................................ 440

PARTICIPATING BEHAVIORAL HEALTH PROVIDERS .......................................................................................................... 441

AUTISM .................................................................................................................................................................................. 441 BEHAVIOR ANALYSIS ................................................................................................................................................................. 447 COUNSELING ........................................................................................................................................................................... 447 GERIATRIC PSYCHIATRY .............................................................................................................................................................. 460 MARRIAGE AND FAMILY THERAPY ................................................................................................................................................ 460 MENTAL HEALTH SERVICES ........................................................................................................................................................ 464 NEUROPSYCHOLOGY ................................................................................................................................................................. 466 PSYCHIATRY............................................................................................................................................................................. 467 PSYCHIATRY, CHILD AND ADOLESCENT .......................................................................................................................................... 471 PSYCHOLOGY ........................................................................................................................................................................... 472 PSYCHOLOGY, CHILD AND ADOLESCENT ........................................................................................................................................ 481 SOCIAL WORK ......................................................................................................................................................................... 481

INDEX OF PROVIDERS BY LANGUAGES SPOKEN ............................................................................................................... 504

INDEX .............................................................................................................................................................................. 583

Healthy Premier - Individual & Family General Information

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Directories are subject to change. Members may be responsible for out-of-pocket expenses if a provider is non-participating.

Members are encouraged to confirm that a provider is participating with their plan, prior to scheduling an appointment. If

you have questions or need a translator, please contact our Customer Service Department at 801-587-6480.

University Health Plans

https://uhealthplan.utah.edu/

General Information

My Doctors: Name:

Phone:

Name:

Phone:

Name:

Phone:

Name:

Phone:


Member Services: Phone: (801) 587-6480 or 1-888-271-5870, option 6

Hours: Mon – Fri, 8AM – 6 PM

Email: [email protected]

Fax: (801) 587-6433


Website Address: https://uhealthplan.utah.edu/


Claims: Phone: (801) 587-6480 or 1-888-271-5870, option 6

Mail to: P.O. Box 45180

Salt Lake City, UT 84145-0180


Case Management: (801) 587-6480 or 1-888-271-5870, option 2

Because providers may be added to or deleted from University Health Plans at any time, please verify

their participation by calling University Health Plans Customer Service at (801) 587-6480, option 6.

https://uhealthplan.utah.edu/mailto:[email protected]://uhealthplan.utah.edu/

Healthy Premier - Individual & Family Welcome

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WELCOME TO HEALTHY PREMIER - INDIVIDUAL & FAMILY

This directory lists the providers in the Healthy Premier - Individual & Family network. You will have the lowest out-of-pocket cost when you receive services from these providers.

Choosing Your Doctor: A Primary Care Physician (PCP) is a doctor you see for most of your medical care. Healthy Premier - Individual & Family PCPs are listed in the front of this handbook. You do not have to pick a PCP; but we think you should. A PCP will:

See you for routine check-ups.

Treat you when you are sick or injured.

Refer you to a specialist (if needed).

Approve all non-emergency hospital stays.

Be your contact if you need care after office hours (except emergencies).

Choose a PCP from the list of providers in this directory. These are the kinds of doctors who are PCPs:

Family or General Practice (for all ages)

Internal Medicine (for adults)

Pediatrician (for children)

Obstetrics and Gynecology (OB/GYN – for women). You may also choose a Certified Nurse Midwife (CNM) if you are having a baby.

You may select one PCP for your whole family or a different PCP for every family member with Healthy Premier - Individual & Family as their health plan. If you have a special health need, you may be able to choose a specialist as your PCP. A Case Manager will work with you to choose a specialist as your PCP. Our Case Managers are Registered Nurses. They will work with you and your doctor(s) to make sure you get the care you need. The Healthy Premier - Individual & Family plan provides access to providers and facilities for covered services under your benefit plan. Providers and facilities were selected based on our specific criteria for cost and quality. We survey our members periodically to determine member satisfaction. We look at the number of providers

and facilities in the counties where our plans provide coverage to members. We make sure that members can access our providers and facilities within a reasonable driving distance and/or time.

Remember: Go to the emergency room if you have an Emergency Medical Condition that requires Emergency Service. Do not go to the emergency room, though, for routine medical care. If you think your medical problem might be an emergency, call 911 or go to any hospital emergency room. “Emergency Medical Condition” means, unless otherwise defined in an applicable Benefit Plan, a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that a prudent layperson, who possesses an average knowledge of medicine and health, could reasonably expect the absence of immediate medical attention to result in: (a) placing the patient’s health (or, with respect to a pregnant woman, the health of a woman or her unborn child) in serious jeopardy; (b) serious impairment of bodily function; (c) serious dysfunction of any bodily organ or part. Severe bleeding, unconsciousness, and fracture are examples of Emergencies. The determination of whether Emergency Services are Covered Services shall rest with University. Such determination shall be consistent with the definition of “Emergency Medical Condition” as stated above and shall be subject to the appeals process of University. Notwithstanding any other provision in this Agreement, University shall not deny payment for Emergency Services provided by Provider to Members in accordance with USC 42, Section 1395 et seq of the Emergency Medical Treatment and Active Labor Act (EMTALA). “Emergency Services” means covered inpatient and outpatient services that are furnished by a Provider that is qualified to furnish these services and that are needed to evaluate or stabilize an Emergency Medical Condition. For questions about your medical benefits, please call Member Services at 1-888- 271-5870, option 6.


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Important Phone Numbers:

Member Services: 801-587-6480 or 1-888-271-5870

(Choose option 6) Hours: Mon- Fri: 8 a.m.–6 p.m. U of U Physician Referral Service: 801-581-2897 U of U Health Plan members can call our Access Assistance line to help find a provider, transition to an in-network provider or schedule an appointment. To contact a care coordinator, call 801-587-2851.

Healthy Premier - Individual & Family on the Internet: https://uhealthplan.utah.edu/

Claims may be mailed to: HEALTHY PREMIER - INDIVIDUAL & FAMILY Attn: Claims Department

P.O. Box 45180 Salt Lake City, UT 84145



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Healthy Premier - Individual & Family has translators for any language. Please call member services at 1-888-271-5870, option 6. If you have diabetes, heart disease, arthritis or any other chronic condition, Healthy Premier - Individual & Family has a Care Manager ready to assist you to make sure you get the care that you need. Give our Care Management department a call at 801-587-6480 or 1-888-271-5780, option 2.

Spanish ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-271-5870.

Chinese

注意：如果您使用繁體中文，您可以免費獲得語

言援助服務。請致電 1-888-271-5870。

Vietnamese CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-888-271-5870.

Korean

주의: 한국어를 사용하시는 경우, 언어 지원

서비스를 무료로 이용하실 수 있습니다. 1-888-

271-5870 번으로 전화해 주십시오.

Navajo Díí baa akó nínízin: Díí saad bee yáníłti’go Diné Bizaad, saad bee áká’ánída’áwo’dęę’, t’áá jiik’eh, éí ná hólǫ, kojį’ hódíílnih 1-888-271-5870

Nepali

ध्यान दिनुहोस्: तपारं्इले नेपाली बोल्नुहुन्छ भने तपारं्इको

दनम्ति भाषा सहायता सेवाहरू दनिःशुल्क रूपमा उपलब्ध

छ । फोन गनुुहोस् 1-888-271-5870

Tongan FAKATOKANGA’I: Kapau ‘oku ke Lea-Fakatonga, ko e kau tokoni fakatonu lea ‘oku nau fai atu ha tokoni ta’etotongi, pea teke lava ‘o ma’u ia. Telefoni mai 1-888-271-5870

Serbo-Croatian OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite 1-888-271-5870

Tagalog PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-888-271-5870

German ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-888-271-5870

Russian ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-888-271-5870

Cambodian

ប្រយ័ត្ន៖ បរើសិនជាអ្នកនិយាយ ភាសាខ្មែរ,

បសវាជំនួយខ្ននកភាសា បោយមិនគិត្ឈ្ន លួ

គឺអាចមានសំរារ់រំបរ ើអ្នក។ ចូរ ទូរស័ព្ទ 1-888-271-5870

French ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-888-271-5870

Japanese

注意事項：日本語を話される場合、無料の言語

支援をご利用いただけます。1-888-271-5870

Arabic اللغوية المساعدة خدمات فإن ،اللغة اذكر تتحدث كنت إذا :ملحوظة

5870-271-888-1 برقم اتصل .بالمجان لك تتوافر

Healthy Premier - Individual & Family Bienvenidos

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BIENVENIDOS A HEALTHY PREMIER - INDIVIDUAL & FAMILY Este directorio enumera a los proveedores en la red de Healthy Premier - Individual & Family. Usted tendrá el más bajo de los gastos de bolsillo cuando recibe servicios de estos proveedores.

Escogiendo a Su Doctor: Un Médico de Atención Primaria (PCP) es un doctor al que usted ve en la mayoría de sus atenciones médicas. Los PCP de Healthy Premier - Individual & Family aparecen en la parte de atrás de este manual. No tiene que escoger a un PCP, pero creemos que debería. Un PCP realizará lo siguiente:

Lo verá para chequeos de rutina.

Lo atenderá cuando esté enfermo o lesionado.

Lo referirá a un especialista (de ser necesario).

Aprobará todas las hospitalizaciones que no sean de emergencia.

Será su contacto si necesita que lo atiendan fuera del horario del consultorio (excepto las emergencias).

Escoja a un PCP de la lista de proveedores que aparece en este manual. Estas son las clases de doctores que son PCP:

Práctica Familiar (para todas las edades)

Medicina Interna (para adultos)

Pediatría (para niños)

Obstetricia y Ginecología (OB/GYN – para mujeres). También puede escoger una Enfermera Obstétrica Certificada (CNM) si va a tener un bebé.

Puede escoger a un PCP para toda su familia, o un PCP diferente para cada miembro de la familia que tiene Healthy Premier - Individual & Family como su plan de salud. Si tiene una necesidad especial de salud, puede escoger a un especialista como su PCP. Un Administrador de Caso trabajará con usted para escoger a un especialista como su PCP. Nuestros Administradores de Caso son Enfermeras Registradas. Ellas trabajarán con usted y su doctor(es) para asegurarse de que usted reciba la atención que necesita.

El plan Healthy Premier - Individual & Family

proporciona acceso a los proveedores y las

instalaciones para los servicios cubiertos por su plan

de beneficios. Se seleccionaron los proveedores y

las instalaciones en base a los criterios específicos

de costo y calidad. Hacemos encuestas a nuestros

miembros periódicamente para determinar la

satisfacción de los miembros. Nos fijamos en el

número de proveedores e instalaciones en los

condados donde nuestros planes proporcionan

cobertura a los miembros. Nos aseguramos de que

los miembros puedan acceder a nuestros

proveedores e instalaciones dentro de una

razonable distancia o tiempo.

Recuerde: Vaya a la sala de emergencias si tiene

una a condición médica de emergencia que

requiere un servicio de emergencia. No vaya a la

sala de emergencia si se trata de una atención

médica de rutina. Si usted piensa que su problema

médico puede ser una emergencia, llame al 911 o

vaya a la sala de emergencia de cualquier hospital.

“Condición de Emergencia Médica” significa a menos que se defina lo contrario en un Plan de Beneficios aplicable, una condición médica que se manifiesta por síntomas agudos de suficiente gravedad, incluyendo dolor severo. De tal manera que un laico prudente, que posee un conocimiento promedio de medicina y salud, podría razonablemente esperar que la ausencia de atención médica inmediata resulte en: (a) poner en grave peligro la salud del paciente (o, con respecto a una mujer embarazada, la salud de una mujer o su feto); (b) deterioro grave de la función corporal; (c) disfunción grave de cualquier órgano o parte del cuerpo. El sangrado severo, la inconsciencia y fracturas son ejemplos de emergencias. La determinación de si los Servicios de Emergencia son Servicios Cubiertos dependerá de la Universidad. Dicha determinación deberá ser consistente con la definición de “Condición de Emergencia Médica” como se indicó anteriormente y estará sujeto al proceso de apelación de la Universidad. No obstante, cualquier otra disposición en este Acuerdo, la Universidad no negará el pago por los Servicios de Emergencia proporcionados por el Proveedor a los Miembros de conformidad con la USC 42, Sección 1395 y siguientes de la Ley de Tratamiento Médico de Emergencia y Trabajo Activo (EMTALA).

Healthy Premier - Individual & Family Bienvenidos

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"Servicios de Emergencia" se refiere a los servicios cubiertos para pacientes hospitalizados y ambulatorios que proporciona un proveedor que está calificado para brindar estos servicios y que son necesarios para evaluar o estabilizar una condición médica de emergencia.

Si tiene preguntas respecto de sus beneficios

médicos, llame a los Servicios para Miembros al 1-

888-271-5870, opción 6.

Números Telefónicos Importantes:

Servicios Para Miembros: 801-587-6480 o 1-888-271-5870

(Escoja la opción 6) Horario: lunes - viernes: 8:00 a.m.- 6:00 p.m. U de U Servicio de Referencia Médica: 801-581-2897 Los miembros de U of U Health Plan pueden llamar a nuestra línea de Asistencia de Acceso para ayudar a encontrar un proveedor, hacer la transición a un proveedor dentro de la red o programar una cita. Para comunicarse con un coordinador de atención, llame al 801-587-2851.

Healthy Premier - Individual & Family en Internet: https://uhealthplan.utah.edu/

Envíe sus reclamos a: HEALTHY PREMIER - INDIVIDUAL & FAMILY Attn: Claims Department

P.O. Box 45180 Salt Lake City, UT 84145

Healthy Premier - Individual & Family tiene traductores

para cualquier idioma. Por favor, llame a Servicios para

Miembros al 1-888-271-5870, opción 6.

Si usted tiene diabetes, enfermedades del corazón, artritis

o cualquier otra enfermedad crónica, Healthy Premier -

Individual & Family tiene un Administrador de Atención

disponible para ayudarle y para asegurarse de que usted

reciba la atención médica que necesita. Llame a nuestro

departamento de Administración de la Atención al 801-

587-6480 o 1-888-271-5870, opción 2.


Healthy Premier - Individual & Family University of Utah Health Plans Contracting Criteria

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The University of Utah Health Plans (UUHP) contracts with physicians and other health care professionals and

facilities for all of our product lines, including commercial, marketplace, and Medicaid, to offer provider networks

essential to the delivery of health care and services to our members. UUHP is committed to the “triple aim” of

improving experience and quality of care, improving the health of populations, and reducing the per capita cost of

care.

We recognize the importance of population health and payment reform and have developed extensive care

management and value-based payment programs that improve health and align provider reimbursement with value

and positive outcomes.

Provider applications to participate in any UUHP network are considered based on the following:

UUHP business needs which may include and are not limited to:

• Network adequacy requirements based on state and/or federal guidelines • Network adequacy requirements based on the current or expected population of a given

geographic area (usually defined by county or zip code) • Network adequacy requirements based on provider type and/or specialty • Network composition based on scope of services required by payer such as employer, health

plan, union/trust, government entity, etc. • Demographic needs including but not limited to languages spoken • Existing, non-compensated, referral patterns with current network providers and/or UUHP

members

Quality, patient experience and cost data as available which may include and is not limited to:

Comparisons of provider practice data to benchmark market averages related to compliance

with industry-standard quality measures. Examples include: Hemoglobin A1c (HbA1c) testing

in diabetic patients, breast cancer screening prevention rates, and child immunization rates.

Industry published and available patient surveys and reviews

Comparisons of provider practice cost data to benchmark market averages on a per-member-

per-month basis for similar populations

The credentialing process which may include and is not limited to, verifying appropriate licensure, education

and training, board certification, DEA licensure, accreditation/certification status, review of sanctions and a

review of an acceptable history of professional liability claims.

All providers must be approved through our credentialing process before they may participate in any network.

UUHP plans are designed based on specific criteria that we apply to select participating primary care physicians and specialists which include:

Cardiology

General Surgery

Neurology

Urology

Orthopedics

Obstetrics and Gynecology Additional primary care physicians, specialists, and facilities are included if they meet our credentialing requirements to ensure members have access within a reasonable distance to the number and types of providers needed.

Healthy Premier - Individual & Family Participating Facilities & Ancillary Services

07/08/2019 Page 13




♿ ADA accesible ㏄ Cultural Competency training

Hospitals

Beaver Beaver Valley Hospital

1109 N 100 West St ...... (435) 438-7100

Blanding Blue Mountain Hospital

802 S 200 W ................. (435) 678-3993

Bountiful Lakeview Hospital

630 E Medical Dr .......... (801) 299-2200

Brigham City Brigham City Community Hospital

950 S Medical Dr .......... (435) 734-9471

Burley, ID Cassia Regional Hospital ♿

1501 Hiland Ave ........... (208) 678-4444

Butte City, ID Lost Rivers Medical Center

551 Highland Dr ........... (208) 252-7654

Cedar City Cedar City Hospital ♿

1303 N Main St............. (435) 868-5000

Delta Delta Community Hospital ♿

126 White Sage Ave ..... (435) 864-5591

Draper Lone Peak Hospital

11925 S State St ........... (801) 545-8000

Fillmore Fillmore Community Hospital ♿

674 South Hwy 99 ........ (435) 743-5591

Grand Junction, CO Community Hospital

2351 G Rd ..................... (970) 242-0920

Gunnison Gunnison Valley Hospital

64 E 100 N .................... (435) 528-7246

Heber City Heber Valley Medical Center ♿

1485 South Hwy 40 ...... (435) 654-2500

Idaho Falls, ID Eastern Idaho Regional Medical Center

3100 Channing Way ..... (208) 529-6111

Kanab Kane County Hospital

355 N Main St............... (435) 644-5811

Logan Logan Regional Hospital ♿

500 E 1400 N ................ (435) 716-1000

Malad City, ID Nell J. Redfield Memorial Hospital

150 N 200 W ................ (208) 766-2231

Milford Milford Memorial Hospital

850 N Main St

Ut Hwy 257 .................. (435) 387-2411

Moab Moab Regional Hospital

450 W Williams Way .... (435) 719-4550

Monticello San Juan Hospital

380 W 100 N ................ (435) 587-2116

Mt. Pleasant Sanpete Valley Hospital ♿

1100 S Medical Dr ........ (435) 462-2441

Nephi Central Valley Medical Center

48 W 1500 N ................ (435) 623-3000

North Logan Cache Valley Hospital

2380 N 400 E ................ (435) 713-9700

Ogden Ogden Regional Medical Center

5475 S 500 E ................ (801) 479-2111

Orem Timpanogos Regional Hospital

750 W 800 N ................ (801) 714-6000

Panguitch Garfield Memorial Hospital

200 N 400 E .................. (435) 676-8811

Park City Park City Hospital ♿

900 Round Vly Dr ......... (435) 658-7000

Payson Mountain View Hospital

1000 E 100 N ................ (801) 465-7000

Price Castleview Hospital

300 N Hospital Dr ......... (435) 637-4800

Rexburg, ID Madison Memorial Hospital

450 E Main St ............... (208) 359-6900

Richfield Sevier Valley Hospital ♿

1000 N Main St ............ (435) 893-4100

Riverton Primary Children's Unit at Riverton

Hospital ♿

3741 W 12600 S............ (801) 285-4000

Rock Springs, WY Memorial Hospital of Sweetwater County

1200 College Dr ............ (307) 362-3711

Roosevelt Uintah Basin Medical Center

250 W 300 N ................. (435) 722-4691

Uintah Basin Medical Center - Clinic 1

210 W 300 N ................. (435) 722-4691

Salt Lake City Huntsman Cancer Institute

2000 Cir Of Hope .......... (801) 585-0303

Primary Children's Hospital ♿

100 N Mario Capecchi

Dr................................ (801) 662-1000

Shriners Hospitals for Children

1275 E Fairfax Rd At

Virginia St ................... (801) 536-3500

St. Mark's Hospital

1200 E 3900 S ............... (801) 268-7111

University of Utah Hospital

50 N Medical Dr ............ (801) 581-2121

UUHC University Orthopaedic Center

590 Wakara Way .......... (801) 587-7109

St. George Dixie Regional Medical Center ♿

1380 E Medical Ctr Dr ... (435) 251-1000

Taylorsville St. Mark's Taylorsville Emergency Center

5400 S 2700 W.............. (801) 982-0050

Tooele Mountain West Medical Center

2055 N Main St ............. (435) 843-3710

Tremonton Bear River Valley Hospital ♿

905 N 1000 W ............... (435) 207-4500

Vernal Ashley Regional Medical Center

150 W 100 N ................. (435) 789-3342

Hospitals, Long Term Acute Care

(LTAC)

Bountiful South Davis Community Hospital

485 E 500 S ................... (801) 397-8177

Murray Promise Hospital of Salt Lake

4252 Birkhill Blvd .......... (801) 408-7100


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Provo Utah Valley Specialty Hospital

306 West Riv Bnd Ln .... (801) 226-8880

Hospitals, Psychiatric

Bountiful Lakeview Hospital

630 E Medical Dr .......... (801) 299-2200

Grand Junction, CO West Springs Hospital

515 28 3/4 Rd ............... (970) 263-4918

Idaho Falls, ID Eastern Idaho Regional Medical Center

3100 Channing Way ..... (208) 529-6111

Orem Provo Canyon Behavioral Hospital ♿

1350 E 750 N ................ (801) 852-2273

Payson Mountain View Hospital

1000 E 100 N ................ (801) 465-7000

Roosevelt Uintah Basin Medical Center

250 W 300 N ................ (435) 722-4691

Salt Lake City St. Mark's Hospital

1200 E 3900 S ............... (801) 268-7111

University Neuropsychiatric Institute

(UNI)

501 Chipeta Way .......... (801) 583-2500

University of Utah Hospital

50 N Medical Dr ........... (801) 581-2121

Urgent Care Centers

American Fork Medallus Medical - American Fork

476 N 900 W Ste C ....... (801) 492-1611

Bountiful FirstMed Urgent Care - North

1512 Renaissance Towne Dr

Ste 100 ......................... (801) 295-6483

Ogden Clinic - Cope Family Medicine

Urgent Care

185 S 400 E Ste 100 ...... (801) 397-6200

Brigham City Box Elder InstaCare

1050 S 500 W ............... (435) 695-2727

Burley, ID Riverview Urgent Care and Medical

Center

382 N Overland Ave ..... (208) 678-6996

Casper, WY Cedars Health - Casper

428 S Durbin St

Ste 104 ......................... (307) 337-4284

Cedar City Cedar City InstaCare

962 Sage Dr .................. (435) 865-3440

Centerville UUHC Centerville Health Center - Urgent

Care

26 S Main St ................. (801) 213-8844

Cheyenne, WY Cedars Health - Cheyenne

1421 W Lincoln Way .... (307) 637-6707

North Cheyenne Medical - Cheyenne

6501 Sycamore Rd

Ste F1 ........................... (307) 514-1300

Cottonwood Heights FirstMed Urgent Care - East

1950 E 7000 S .............. (801) 943-3300

Draper Medallus Medical - Draper

1126 E 12300 S ............ (801) 545-0600

Eagle Mountain Eagle Mountain Family Medicine &

Urgent Care - Revere Health

4095 E Pony Expy Pkwy

Ste 1 ............................. (801) 429-8037

Farmington Ogden Clinic - Farmington Urgent Care

991 W Shepard Ln ........ (801) 397-6080

UUHC Farmington Health Center - Urgent

Care

165 N University Ave ... (801) 213-3200

Farr West Farr West Urgent Care & Family

Medicine

2850 N 2000 W ............ (801) 732-0805

Revere Health Family medicine

2850 N 2000 W

Ste 101 ......................... (801) 866-0170

Grand Junction, CO Community Hospital

2351 G Rd .................... (970) 242-0920

Hailey, ID Sterling Urgent Care - Hailey

507 S Main St ............... (208) 788-4122

Heber City Heber InstaCare

1485 South Hwy 40

Ste G ............................ (435) 657-4500

Holladay Medallus Medical - Holladay

3934 S 2300 E Ste D ...... (801) 849-8500

Hurricane Hurricane Valley InstaCare

75 N 2260 W ................. (435) 635-6550

Hyde Park North Cache Valley InstaCare

4088 North Hwy 91 ...... (435) 563-4888

Idaho Falls, ID Sterling Urgent Care - Idaho Falls

740 S Woodruff Ave ..... (208) 542-9111

Jerome, ID Urgent Care of Jerome

133 West Ave A Ste B ... (208) 324-2004

Layton Medallus Medical - Layton

1868 N 1200 W ............. (801) 614-9030

Ogden Clinic - Davis Family Physicians

Urgent Care

3225 W Gordon Ave ..... (801) 397-6150

Wee Care Pediatrics - Layton Office

2084 N 1700 W Ste A .... (801) 773-8644

Lehi Utah Valley Urgent Care & Family

Practice - Lehi

127 E Main St Ste E ....... (801) 766-9822

Logan Logan InstaCare

412 N 200 E .................. (435) 713-2710

Sterling Urgent Care - Logan

1201 S Main St

Ste 110.......................... (435) 787-8504

Sterling Urgent Care - North Logan

630 E 1400 N Ste 150 ... (435) 915-4465

Magna Exodus Healthcare Network - Magna

Health Center

3665 S 8400 W

Ste 110.......................... (801) 250-9638

Midvale UUHC Greenwood Health Center -

Urgent Care

7495 S State St .............. (801) 213-8840

Mt. Pleasant Mt. Pleasant Family Medicine & Urgent

Care - Revere Health

1075 South Hwy 89 ...... (435) 462-2044


07/08/2019 Page 15





Murray FirstMed Urgent Care - Murray

5911 S Fashion Pl

Blvd ............................ (801) 266-6843

Ogden Ogden Clinic - Canyon View Urgent Care

1159 E 12Th St ............. (801) 475-3700

Ogden Clinic - Professional Center Urgent

Care

4650-4700 South

Harrison Blvd ............. (801) 475-3000

Ogden Clinic - Skyline Urgent Care

6112 S 1550 E ............... (801) 475-3800

Ogden Clinic - South Ogden Center for

Family Medicine Urgent Care

5740 Crestwood Dr ...... (801) 479-7771

Orem Utah Valley Urgent Care & Family

Practice - Orem

960 W 800 N ................ (801) 326-0678

UUHC Parkway Health Center - Urgent

Care

145 W University

Pkwy........................... (801) 234-8585

Park City Stat MD Urgent Care Park City

1784 W Uinta Way

Ste E-2 .......................... (435) 601-0160

UUHC Redstone Health Center - Urgent

Care

1743 W Redstone Ctr Dr

Ste 115 ......................... (435) 658-9262

Payson Payson Family Medicine & Urgent Care -

Revere Health

97 Professional Way

Ste 2 ............................. (801) 465-4896

Pleasant View Ogden Clinic - Mountain View Urgent

Care

1100 W 2700 N ............ (801) 475-3600

Price Gagon Family Medicine & Urgent Care

377 N Fairgrounds Rd ... (435) 613-2200

Provo Provo Family Medicine & Urgent Care -

Revere Health

1055 N 500 W Bldg A ... (801) 812-5033

Riverwoods Urgent Care

280 W Riverpark Dr

Ste 120 ......................... (801) 229-2011

Rawlins, WY Cedars Health - Rawlins

1906 E Cedar St ............ (307) 324-2294

Rexburg, ID Fall River Family Medicine and Urgent

Care

21 Winn Dr ................... (208) 881-5222

Riverton, WY Cedars Health - Riverton

716 College Vw Dr........ (307) 856-1315

Riverton Granger Medical Riverton - Urgent Care

12391 S 4000 W ........... (801) 302-1700

Medallus Medical - South Bangerter

13348 S Market Ctr Dr

Ste 100 ......................... (801) 844-1600

Rock Springs, WY Cedars Health - Rock Springs

1453 Dewar Dr Ste A .... (307) 382-2466

Red Desert Insta-Care

2761 Commercial

Way ........................... (307) 382-3064

Roy Ogden Clinic - Grand View Urgent Care

3485 N 5200 S .............. (801) 475-3900

Roy Rock Run Family Medicine & Urgent


5640 S 3500 W ............. (801) 773-2838

Salem Salem Urgent Care - Revere Health

555 W Sr 164 N ............ (801) 465-4896

Salt Lake City FirstMed Urgent Care - Central

441 S Redwood Rd ....... (801) 973-2588

Granger Medical Millcreek - Urgent Care

1121 E 3900 S Ste 130.. (801) 281-1300

Revere Health - Clinton

1407 N 2000 W Ste C ... (801) 866-0170

University of Utah Hospital - Urgent Care

50 N Medical Dr ........... (801) 581-2121

UUHC Orthopaedic Center Injury Clinic

590 Wakara Way.......... (801) 587-7109

UUHC Redwood Health Center - Urgent

Care

1525 W 2100 S ............. (801) 213-9900

Sandy Medallus Medical - Sandy

7998 S 1300 E .............. (801) 255-2000

Sheridan, WY Cedars Health - Sheridan

813 Highland Ave ......... (307) 673-5501

South Jordan Copperview Medical Center

3556 W 9800 S

Ste 101.......................... (801) 567-9780

Medallus Medical - South Jordan

10433 S Redwood Rd .... (801) 501-0500

UUHC South Jordan Health Center -

Urgent Care

5126 W Daybreak

Pkwy ........................... (801) 213-4500

St. George River Road InstaCare

577 South Riv Rd .......... (435) 688-6300

St. George Clinic Urgent Care - Revere

Health

736 S 900 E Ste 203 ...... (435) 673-6131

Sunset InstaCare

1739 W Sunset Blvd ...... (435) 634-6050

Stansbury Park Tooele Valley Urgent Care

1244 N Main St

Ste 201.......................... (435) 882-3968

Twin Falls, ID Urgent Care of Twin Falls

2392 Addison Ave E ...... (208) 933-4440

Washington Washington Family Medicine & Urgent


195 W Telegraph St ...... (435) 215-0600

West Jordan FirstMed Urgent Care - West Jordan

8822 S Redwood Rd

Ste E-122 ...................... (801) 256-0009

Granger Medical West Jordan - Urgent

Care

3181 W 9000 S.............. (801) 352-5900

Stat MD Urgent Care West Jordan

7724 S 5600 W

Ste 102.......................... (801) 432-8480

West Valley City Granger Medical West Valley - Urgent

Care

3725 W 4100 S.............. (801) 965-3600

Medallus Medical - West Valley

3451 S 5600 W Ste F ..... (801) 957-0900

UUHC Westridge Health Center - Urgent

Care

3730 W 4700 S.............. (801) 213-8843


07/08/2019 Page 16





Ambulance Services

Green River, WY Castle Rock Medical Center

1400 Uinta Dr ............... (307) 872-4500

Rexburg, ID Madison County Ambulance

26 North Ctr St ............. (208) 359-3010

Public Health Centers / Clinics

Beaver Southwest Utah Public Health

Department - Beaver

75 W 1175 N ................ (435) 438-2482

Brigham City Bear River Health Department - Brigham

City

817 W 950 S ................. (435) 734-0845

Castle Dale Southeastern Utah District Health

Department - Castle Dale

25 W Main St ................ (435) 381-2252

Cedar City Southwest Utah Public Health

Department - Cedar City

260 E Dl Sargent Dr ...... (435) 586-2437

Delta Central Utah Public Health Dept - West

Millard Office

428 E Topaz Blvd .......... (435) 864-3612

Farmington Davis County Health Department

22 S State St ................. (801) 525-5041

Fillmore Central Utah Public Health Dept - East

Millard Office

40 N 400 W .................. (435) 743-5723

Heber City Wasatch County Health Department

55 S 500 E ..................... (435) 657-3257

Junction Central Utah Public Health Dept - Piute

550 N Main St............... (435) 577-2521

Kanab Southwest Utah Public Health

Department - Kanab

445 N Main St............... (435) 644-2537

Loa Central Utah Public Health Dept - Wayne

Office

18 S Main St ................. (435) 836-1317

Logan Bear River Health Department - Logan

655 E 1300 N ................ (435) 792-6500

Manti Central Utah Public Health Dept - South

Sanpete Office

40 W 200 N .................. (435) 835-2231

Moab Southeastern Utah District Health

Department - Moab

575 S Kane Crk Blvd ..... (435) 259-5602

Mt. Pleasant Central Utah Public Health Dept - North

Sanpete Office

20 S 100 W ................... (435) 462-2449

Nephi Central Utah Public Health Dept - Juab

Office

160 N Main St .............. (435) 623-0696

Ogden Weber-Morgan Health Department

477 23rd St .................. (801) 399-7252

Panguitch Southwest Utah Public Health

Department - Panguitch

601 East Ctr St.............. (435) 676-8800

Price Southeastern Utah District Health

Department - Price

28 S 100 E .................... (435) 637-3671

Richfield Central Utah Public Health Dept - Sevier

Office

70 Westview Dr ........... (435) 896-5451

Rock Springs, WY Sweetwater County Community Nursing

Services

333 Broadway St

Ste 110 ......................... (307) 922-5390

St. George Southwest Utah Public Health

Department - St. George

620 S 400 E Ste 400...... (435) 986-2545

Tooele Tooele County Health Department

151 N Main St .............. (435) 277-2300

Tremonton Bear River Health Department -

Tremonton

40 W 100 N .................. (435) 257-3318

Rural Health Clinics

Mackay, ID Mackay Medical Clinic

313 Hwy 93 ................... (208) 588-2993

Addiction Treatment

Sandy AD Psychotherapy and Clinical Consulting

8465 S 700 E ................. (801) 233-8577

Ambulatory Behavioral Health

Clinics

Brigham City Bear River Health Department - Brigham

City

817 W 950 S.................. (435) 734-0845

Harrisville Aloha Behavioral Consultants ♿

811 N Harrisville Rd ...... (801) 399-1818

Logan Bear River Health Department - Logan

655 E 1300 N ................ (435) 792-6500

Roosevelt Northeastern Counseling Center -

Roosevelt ♿

285 W 800 S.................. (435) 725-6300

Tremonton Bear River Health Department -

Tremonton

40 W 100 N ................... (435) 257-3318

Vernal Northeastern Counseling Center - Vernal

♿

1140 W 500 S................ (435) 725-6300

Ambulatory Surgery Centers

American Fork Revere Health - American Fork Surgery

Center

1175 E 50 S Ste 101 ...... (801) 492-5994

Bountiful Lakeview Endoscopy Center

620 E Medical Dr

Ste 200.......................... (801) 296-2122

Mountain West Surgical Center

1551 S Renaissance Towne Dr

Ste 200.......................... (801) 383-1111


07/08/2019 Page 17





Draper EyeSurg of Utah ♿

11820 S State St

Ste 150 ......................... (801) 568-0200

Grand Junction, CO Endoscopy Center of Grand Junction

1035 Wellington Ave .... (877) 579-4572

Endoscopy Center of Western Colorado

2460 Patterson Rd # 4 .. (970) 245-0990

Idaho Falls, ID Grand Teton Surgical Center ♿

2290 Coronado St ........ (208) 524-3800

Idaho Eye Surgicenter - Idaho Falls ♿

2025 E 17th St .............. (208) 656-7867

Idaho Foot Surgery Center

1540 Elk Crk Dr ............. (208) 904-3359

Madison Avenue Surgery Center

1855 Madison Ave ....... (208) 497-0535

Sunnyside Surgery Center

3345 S Holmes Ave

Ste B ............................. (208) 528-2858

Laramie, WY Premier Bone and Joint Centers - Laramie

1909 Vis Dr ................... (307) 745-8851

Logan South Pointe Surgical Center ♿

810 S 100 N Ste 120 ..... (435) 213-1917

Murray Family Surgical Suite - Murray

151 E 5600 S Ste 104 .... (801) 288-1211

Ogden Mt. Ogden Surgical Center

4364 Washington

Blvd ............................ (801) 479-4470

Pocatello, ID Idaho Eye Surgicenter - Pocatello ♿

1157 Call Pl ................... (208) 232-2008

Providence Spring Creek Surgical Center

65 North Gtwy Dr

Ste 3 ............................. (435) 535-3257

Provo Central Utah Surgical Center

1067 N 500 W .............. (801) 374-0354

Rexburg, ID Idaho Eye Surgicenter - Rexburg ♿

491 1st American Cir .... (208) 359-1130

Madison Memorial Outpatient Surgery

Center

381 E 4th N Ste 200 ...... (208) 359-2300

Upper Valley Surgery Center ♿

256 N 2nd E Ste 1 ......... (208) 419-0351

Rupert, ID Mini - Cassia Surgical

1218 9th St Ste 10 ........ (208) 436-8340

Salt Lake City Mountain West Endoscopy Center

6360 S 3000 E Ste 320.. (801) 944-3166

St. Mark's Outpatient Surgery Center

1250 E 3900 S Ste 100.. (801) 262-0358

Wasatch Endoscopy Center

1220 E 3900 S Ste 1B ... (801) 281-4258

Sandy Granite Peaks Endoscopy

10150 S Petunia Way ... (801) 619-1115

Lone Peak Surgery Center

10011 Centennial Pkwy

Ste 100 ......................... (801) 233-9300

South Ogden Ridgeline Endoscopy Center

6028 S Ridgeline Dr

Ste 100 ......................... (801) 475-4900

St. George Coral Desert Surgery Center

1490 E Foremaster Dr

Bldg C ........................... (435) 674-5230

St. George Surgical Center

676 South Blf St ........... (435) 673-0095

Zion Surgery Center ♿

1791 E 280 N ................ (435) 656-2020

Tooele NorthPointe Surgical Center ♿

2326 N 400 E

Bldg C Ste 100 .............. (435) 843-0180

West Jordan Family Surgical Suite - West Jordan

8822 S Redwood Rd

Ste C-113...................... (801) 748-1427

West Valley City Utah Surgical Center

3715 W 4100 S ............. (801) 957-0200

Cardiac Monitoring

Out of State Preventice Services

Houston, TX ................. (888) 500-3522

Diabetes Education Centers

Bountiful Lakeview Hospital Diabetes Education

630 E Medical Dr .......... (801) 299-6868

Cedar City Cedar City Diabetes Education Clinic

110 W 1335 N

Ste 100.......................... (435) 868-5576

Heber City Heber Valley Diabetes Clinic

380 E 1500 S Ste 204 .... (435) 657-4311

Logan Budge Diabetes Clinic

1350 N 500 E ................ (435) 792-1710

Logan Regional Hospital Diabetes

Services

500 E 1400 N ................ (435) 716-5669

Mt. Pleasant Sanpete Valley Hospital Diabetes

Education

1100 S Medical Dr ........ (435) 462-4163

Provo Utah Valley Diabetes Management Clinic

1034 N 500 W ............... (801) 357-7546

Richfield Sevier Valley Hospital Diabetes Services

1000 N Main St ............. (435) 893-0640

Riverton Primary Children's Outpatient

Endocrinology/Diabetes

3773 W 12600 S............ (801) 213-3599


Diabetes Education

1200 College Dr ............ (307) 922-5390

Salt Lake City Byram Healthcare Diabetes Specialty

Center

3793 S State St .............. (801) 268-9699

Primary Children's Hospital Diabetes

Clinic

81 N Mario Capecchi

Dr................................ (801) 213-3599

St. Mark's Hospital Diabetes Center

1160 E 3900 S

N Medical Ofc Bldg

Ste 3300 ..................... (801) 268-7358

Utah Diabetes & Endocrinology Center

615 Arapeen Dr

Ste 100.......................... (801) 581-7761

St. George Dixie Regional Medical Center Diabetes

Education Clinic

348 E 600 S 2nd Fl ........ (435) 251-2888


07/08/2019 Page 18





Tremonton Bear River Valley Diabetes and

Endocrinology

905 N 1000 W .............. (435) 207-4500

Diabetes Supply Centers

Centerville UUHC Centerville Health Center

Pharmacy

26 S Main St ................. (801) 693-7950

Midvale UUHC Greenwood Health Center

Pharmacy

7495 S State St ............. (801) 213-9540

Ogden Byram Healthcare - Ogden

4421 Harrison Blvd

Ste 1 ............................. (801) 392-2362

Orem UUHC Parkway Health Center Pharmacy

145 W 1300 S ............... (801) 234-8510

Park City UUHC Redstone Health Center Pharmacy

1743 W Redstone Ctr Dr

Ste 115 ......................... (435) 658-9280

Provo Byram Healthcare - Provo

1254 N State St

Riverside Plz ................. (801) 377-1487

Salt Lake City Byram Healthcare - Murray (CSC)

645 E 4500 S Ste 200 .... (800) 775-4372

Byram Healthcare - Salt Lake City

3793 S State St ............. (801) 268-9699

Byram Healthcare - Salt Lake City

615 Arapeen Dr

Ste 100 ......................... (727) 540-0221

JQ Medical Supply

6910 Highland Dr

Ste 4 ............................. (801) 942-8582

University of Utah Hospital Pharmacy

50 N Medical Dr ........... (801) 581-2276

UUHC Redwood Health Center Pharmacy

1525 W 2100 S ............. (801) 213-9950

South Jordan UUHC South Jordan Health Center

Pharmacy

5126 W Daybreak

Pkwy........................... (801) 213-4550

Stansbury Park UUHC Stansbury Health Center Pharmacy

220 Millpond Rd .......... (435) 843-3050

West Valley City UUHC Westridge Health Center

Pharmacy

3730 W 4700 S ............. (801) 213-9250

Dialysis Centers

American Fork UUHC American Fork Dialysis

1159 E 200 N Ste 150 ... (801) 763-0652

Blanding Blue Mountain Hospital

802 S 200 W ................. (435) 678-3993

Bountiful UUHC Lakeside Dialysis

532 S 500 W ................. (801) 299-3470

Cedar City UUHC Iron Mission Dialysis & Kidney

Clinic

1277 Northfield Rd ...... (435) 867-8175

Heber City Heber Valley Dialysis Center at IHC

380 E 1500 S Ste 101.... (435) 654-2500

Heber Valley Dialysis Center at IHC

380 E 1500 S Ste 101.... (435) 654-2500

Hurricane UUHC Hurricane Dialysis & Kidney Clinic

48 S 2500 W Unit 100 .. (435) 635-0399

Idaho Falls, ID UUHC Gem State Dialysis

2225 Teton Plz Ste A .... (208) 522-4831

Kanab Kanab Nephrology Clinic

355 N Main .................. (435) 867-8175

Layton UUHC Farmington Bay Dialysis

942 S Main St ............... (801) 593-9111

Logan Logan Regional Hospital Dialysis Center

550 E 1400 N Ste K ....... (435) 716-5314

Mesquite, NV UUHC Desert Valley Dialysis & Kidney

Clinic

350 Falcon Rdg Pkwy

Bldg 700 Ste 104 .......... (702) 345-4144

Ogden UUHC Bonneville Dialysis

5575 S 500 E ................ (801) 479-0351

UUHC Mark Lindsay Dialysis

1151 E Country Hls Dr .. (801) 479-4460

Payson UUHC Payson Dialysis & Kidney Clinic

15 S 1000 E Ste 50 ........ (801) 465-2060

Pleasant View UUHC Pleasant View Dialysis

2715 North Hwy 89

Ste 15............................ (801) 737-9555

Price UUHC Castleview Dialysis & Kidney Clinic

230 N Hospital Dr

Ste 1.............................. (801) 637-8696

Provo UUHC Provo Dialysis & Kidney Clinic

1675 N Freedom Blvd

Ste 15............................ (801) 373-0167

Rexburg, ID UUHC Yellowstone Dialysis Center

1165 Summers Dr

Ste 15............................ (208) 656-0396

Richfield Sevier Valley Dialysis

81 E 900 N .................... (435) 893-0358


Dialysis

1180 College Dr ............ (307) 352-8216

Roosevelt Uintah Basin Dialysis Center

250 W 300 N ................. (435) 725-2008

Salt Lake City Primary Children's Dialysis Center

81 N Mario Capecchi

Dr................................ (801) 662-1000

UUHC Kidney & Liver Clinic

50 N Medical Dr ............ (801) 581-6709

UUHC Kolff Dialysis

423 Wakara Way

Ste 200.......................... (801) 581-3981

Sandy UUHC South Valley Dialysis

8750 S Sandy Pkwy ....... (801) 233-8745

St. George UUHC Dixie Dialysis & Kidney Clinic

720 South Riv Rd

Ste D-1100 .................... (435) 656-0857

Taylorsville UUHC West Valley Dialysis

3854 W 5400 S.............. (801) 587-8578


07/08/2019 Page 19





Tooele Tooele Valley Dialysis at IHC

196 E 2000 N Ste 112 ... (801) 408-1430

Hearing Centers

Layton Intermountain Hearing Centers - Layton

755 W Antelope Dr ...... (385) 383-7161

Ogden Intermountain Hearing Centers - Ogden

5349 S Adams Ave

Ste C ............................. (801) 479-3346

Rock Springs, WY Intermountain Hearing Centers - Rock

Springs

1573 Dewar Dr Ste 2 .... (307) 362-8221

Home Health Agencies

Ada County, ID Encompass Home

Health and Hospice ........ (208) 519-4330

Bannock County, ID Encompass Home

Health of Idaho -

Pocatello ........................ (208) 637-1100

Beaver County Beaver Valley Hospital -

Home Health &

Hospice .......................... (435) 438-7100

IHC Homecare Home

Health Cedar City ........... (435) 868-5852

Zion's Way Home Health

& Hospice - Cedar City ... (435) 688-0648

Bingham County, ID Blackfoot Home Health .... (208) 782-1084

Bonneville County, ID Advanced Home Health

♿ .................................... (208) 346-7807

Encompass Home

Health of Idaho - Idaho

Falls ................................ (208) 528-8100

IntegriCare of Eastern

Idaho ♿ .......................... (208) 529-0800

Box Elder County Caregiver Support

Network - Box Elder

and Cache Counties ....... (435) 915-3424

Community Nursing

Services (CNS) -

Brigham Office ............... (435) 723-4404

Community Nursing

Services (CNS) - Logan

Office ............................. (435) 752-3355

Community Nursing

Services (CNS) - Ogden

Office ............................. (801) 476-0088

Hearts for Hospice &

Home Health -

Riverdale ........................ (801) 475-0601

IHC Homecare Home

Health Logan.................. (435) 716-5477

Ivy Lane Pediatrics -

Ogden Office.................. (801) 774-9698

Symbii Home Health

and Hospice - Layton ..... (801) 444-0221

Cache County Caregiver Support

Network - Box Elder

and Cache Counties ....... (435) 915-3424

Community Nursing

Services (CNS) -

Brigham Office ............... (435) 723-4404

Community Nursing

Services (CNS) - Logan

Office ............................. (435) 752-3355

Encompass Health

Home Health -

Providence ..................... (435) 753-7001

IHC Homecare Home

Health Logan.................. (435) 716-5477


Ogden Office.................. (801) 774-9698

Rocky Mountain Care -

Logan ............................. (435) 753-8220

Signature Healthcare at

Home - Logan ................ (801) 463-2478

Symbii Home Health

and Hospice - Layton ..... (801) 444-0221

Canyon County, ID Encompass Home

Health of Idaho -

Nampa ........................... (208) 461-1600

Carbon County Community Nursing

Services (CNS) - Price

Office ............................. (435) 613-8887

IHC Homecare Home

Health Mt. Pleasant ....... (435) 462-3431


Price ............................... (435) 637-0665

Daggett County Good Shepherd

Homecare ...................... (435) 789-0499

Davis County A Step Forward -

Clearfield ♿..................... (801) 562-8564

Applegate Homecare &

Hospice - Salt Lake ......... (801) 261-3023

At Home Nursing Care -

North Office ................... (801) 266-5126

Caregiver Support

Network -

Davis/Weber/Morgan

Counties ......................... (801) 547-0060

Community Nursing

Services (CNS) - Layton

Office .............................. (801) 774-4960

Cozy Healthcare Home

Health & Hospice ........... (801) 278-4663

Dignity Home Health -

Weber/Davis County ...... (801) 492-4892

Hearts for Hospice &

Home Health -

Riverdale ........................ (801) 475-0601

Heartwood Home

Health & Hospice ........... (801) 261-9490

IHC Homecare Home

Health Fillmore ............... (435) 743-8821

IHC Homecare Home

Health Ogden ................. (801) 399-1400

IHC Homecare Home

Health Salt Lake .............. (385) 887-6000

Inspiration Home Health .. (801) 281-1314


Ogden Office .................. (801) 774-9698

Legacy Health Care -

Layton ............................ (801) 771-9099


Layton ......................

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