NPI Code Detail JSON Logo

1245459627 NPI number — MEDIPHARM

NPI Number: 1245459627
Health Care Provider/Practitioner: MEDIPHARM

Information about “1245459627” NPI (MEDIPHARM) exists in 1245459627 in HTML format HTML  |  1245459627 in plain Text format TXT  |  1245459627 in PDF (Portable Document Format) PDF  |  1245459627 in an XML format XML  formats.

NPI Number : 1245459627 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245459627",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MEDIPHARM",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 71428",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COTTONWOOD",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84171-0428",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "801-733-9902",
    "MailingAddressFaxNumber": "801-733-9998",
    "FirstLinePracticeLocationAddress": "1260 VINE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SALT LAKE CITY",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84121-1700",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "801-733-9902",
    "PracticeLocationAddressFaxNumber": "801-733-9998",
    "EnumerationDate": "04/24/2007",
    "LastUpdateDate": "08/14/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DUNN",
    "AuthorizedOfficialFirstName": "PAUL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "V.P.",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "801-839-9079",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": "9680-07",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": "375923-1704",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336C0003X",
          "TaxonomyName": "Community/Retail Pharmacy",
          "LicenseNumber": "375923-1704",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336L0003X",
          "TaxonomyName": "Long Term Care Pharmacy",
          "LicenseNumber": "375923-1704",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336S0011X",
          "TaxonomyName": "Specialty Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336S0011X",
          "TaxonomyName": "Specialty Pharmacy",
          "LicenseNumber": "375923-1704",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.