MEDICARE: HAVEN INTEGRATED PHARMACY OPERATIONS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3336C0004X	Compounding Pharmacy
2	3336H0001X	Home Infusion Therapy Pharmacy
3	251F00000X	Home Infusion Agency
4	333600000X	Pharmacy
5	3336S0011X	Specialty Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114773132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAVEN INTEGRATED PHARMACY OPERATIONS

Provider Business Mailing Address
First Line	:	1890 S 3850 W STE 220
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84104-4939
Country	:	US
Telephone Number	:	385-549-1121
Fax Number	:	855-571-3472

Provider Business Practice Location Address
First Line	:	1890 S 3850 W STE 220
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84104-4939
Country	:	US
Telephone Number	:	385-549-1121
Fax Number	:	855-571-3472

Authorized Official
Title or Position	:	PRESIDENT AND PHARMACIST IN CHARGE
Name	:	DR. CHARLES OAXACA HALL
Credential	:	PHARMD
Telephone Number	:	801-604-8736

Provider Enumeration Date	:	04/29/2024
Last Update Date	:	02/02/2026

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Directions to “HAVEN INTEGRATED PHARMACY OPERATIONS ” Practice Location

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