Organization · Type 2 NPI

Granger Medical Clinic PC

Multi-Specialty Clinic/Center · West Jordan, UT

NPI number 1104857549 Active

Practice location

3181 W 9000 So
West Jordan, UT 84088

Call (801) 352-5900 Map

Fax (801) 352-5914

Mailing address

2965 W 3500 S
West Valley City, UT 84119-3602

Specialties and licenses

Taxonomy	Code	License
Multi-Specialty Clinic/Center Primary	261QM1300X	None listed

Multi-Specialty Clinic/Center: Definition to come...

2 other providers at this address

Granger Medical Park CityMulti-Specialty Clinic/Center West Jordan, UT NPI 1699050823
Sandeep Chowdhary, MDPulmonary Disease Physician West Jordan, UT NPI 1891726162

Other multi-specialty clinic/center providers in West Jordan

See all in West Jordan →

NPI record

NPI: 1104857549
Entity type: Organization (Type 2)
Issued: Jul 5, 2006
Last updated: Sep 2, 2025
Status: Active
Subpart: Yes of Granger Medical Clinic PC

Other names

<unavail>
Granger Medical West Jordan · doing business as

Authorized official

Mary Jane Pennington, MD
President
(801) 965-3600

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104857549

Granger Medical Clinic PC's National Provider Identifier is 1104857549, issued on Jul 5, 2006. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in West Jordan, UT. The record was last updated on Sep 2, 2025.