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NPI Code Detail

MEDICARE: MEDICAL CENTER PHARMACY INC

MEDICARE: MEDICAL CENTER PHARMACY INC
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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy3712351703UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14608583OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861495160
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL CENTER PHARMACY INC
Provider Business Mailing Address
First Line : 1050 E SOUTH TEMPLE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1507
Country : US
Telephone Number : 801-350-8140
Fax Number : 801-350-4791
Provider Business Practice Location Address
First Line : 1050 E SOUTH TEMPLE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1507
Country : US
Telephone Number : 801-350-8140
Fax Number : 801-350-4791
Authorized Official
Title or Position : PRESIDENT
Name : JENNA BALDWIN
Credential : PHARMD
Telephone Number : 801-350-8140
Provider Enumeration Date : 05/31/2005
Last Update Date : 09/01/2020

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Directions to “MEDICAL CENTER PHARMACY INC ” Practice Location

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