MEDICARE: MEDS IN MOTION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy	94826851704	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2153397	OTHER		PK

General Provider Information

NPI Number	:	1194101931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDS IN MOTION

Provider Business Mailing Address
First Line	:	4624 S HOLLADAY BLVD
Second Line	:	SUITE 003
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-7054
Country	:	US
Telephone Number	:	801-506-6999
Fax Number	:

Provider Business Practice Location Address
First Line	:	4624 S HOLLADAY BLVD STE 3
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-7054
Country	:	US
Telephone Number	:	801-506-6999
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL RICHARDS
Credential	:
Telephone Number	:	801-915-9301

Provider Enumeration Date	:	08/04/2015
Last Update Date	:	08/04/2015

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Directions to “MEDS IN MOTION ” Practice Location

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