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General NPI Number Information
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NPI Number | 1174928949
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Entity Type | Organization
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Legal Business Name | MMCP
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 2036 E 6200 S
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City | HOLLADAY
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State | UT
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Zip | 84121-2268
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Country | US
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Telephone | 801-559-7719
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Fax | 801-951-7189
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Provider Business Mailing Address
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Address Line | 2036 E 6200 S
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City | HOLLADAY
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State | UT
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Zip | 84121-2268
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Country | US
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Telephone | 801-559-7719
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Fax | 801-951-7189
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | CHAD HAMMON
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Credential |
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Telephone | 801-647-9587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 91894241703
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License Number State | UT
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