Healthcare Provider Details

I. General information

NPI: 1821097221
Provider Name (Legal Business Name): HEALTHWISE PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403B S MAIN ST
SPRINGVILLE UT
84663-2252
US

IV. Provider business mailing address

403B S MAIN ST
SPRINGVILLE UT
84663-2252
US

V. Phone/Fax

Practice location:
  • Phone: 801-489-7300
  • Fax: 801-489-4949
Mailing address:
  • Phone: 801-489-7300
  • Fax: 801-489-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number55310661704
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL TROY JOHNSON
Title or Position: PRINCIPAL OWNER
Credential: R.PH.
Phone: 801-489-7300