BLACK PANDA LLC (NPI# 1518577741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518577741 |
| Entity Type | Organization |
| Organization Name | BLACK PANDA LLC |
| Practice Address |
2507 S State St Salt Lake City UT 84115-3109 |
| Mailing Address |
6280 S Valley View Blvd Ste 734 Las Vegas NV 89118-6833 |
| Practice Telephone | 8555582382 |
| Mailing Telephone | 7022196173 |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-08-03 |
| Authorized Official Name | BARBARA DEINET (MANAGING MEMBER) |
| Authorized Official Telephone | 7022196173 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Aeva Specialty Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | BLACK PANDA LLC | 1350 Avenue of The Americas, 3rd Floor, New York, Ny 10019 |
| Street Address |
2507 S STATE ST |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84115-3109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344198 | Shannon Ballinger | Clinic/Center | 1470 400 W, Salt Lake City, UT 84115 | 2020-10-22 |
| 1992346704 | Anicka Inc | Clinic/Center | 3195 South Main St, Ste 260, South Salt Lake, UT 84115 | 2019-10-02 |
| 1083177505 | Vitor Gabriel Giuliani Alcantara Carioca | Specialist/Technologist | 1850 South Campus Drive, Salt Lake City, UT 84115 | 2019-04-11 |
| 1427528371 | Samuel James Leonhart | Behavior Technician | 354 East Coatsville Drive, Salt Lake City, UT 84115 | 2018-12-04 |
| 1093228645 | Eco Pharmacy LLC | Pharmacy | 3702 S State Street Suite 115, South Salt Lake City, UT 84115 | 2017-11-06 |
| 1568973055 | Eco Apothecary LLC | Pharmacy | 3701 S State Street Suite 114, South Salt Lake City, UT 84115 | 2017-10-24 |
| 1548780455 | Kelly Lund | Case Manager/Care Coordinator | 447 W. Bearcat Dr., Salt Lake City, UT 84115 | 2017-06-21 |
| 1104271238 | The Church of Philadelphia Inc. | Community/Behavioral Health | 2358 South Main Street, Salt Lake City, UT 84115 | 2016-04-26 |
| 1710368626 | Jennifer Swanhild Edwards | Counselor | 140 W 2100 S Ste 244, Salt Lake City, UT 84115 | 2015-06-16 |
| 1508247065 | John Mcguire | Health Educator | 1370 S. West Temple, Salt Lake City, UT 84115 | 2015-06-10 |
| Find all providers in zip 84115 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558919142 | University of Utah | Pharmacy | 1280 E. Stringham Ave, Suite 101, Salt Lake City, UT 84106 | 2019-08-28 |
| 1174928949 | Mmcp | Pharmacy | 6225 S Highland Dr, Salt Lake City, UT 84121-2125 | 2014-10-23 |
| 1164778510 | Meds In Motion | Pharmacy | 3798 S 700 E Ste 7, Salt Lake City, UT 84106-1150 | 2012-08-02 |
| 1013217736 | Acupharm LLC | Pharmacy | 990 W Atherton Dr # 200, Salt Lake City, UT 84123-3465 | 2010-10-28 |
| 1194048918 | Vrx Pharmacy LLC | Pharmacy | 50 E South Temple Ste 145, Salt Lake City, UT 84111-1020 | 2010-03-08 |
| 1164695318 | University of Utah Pharmacies | Pharmacy | 127 S. 500 E., Suite 160, Salt Lake City, UT 84102-2091 | 2008-04-09 |
| 1083763999 | Veridicusrx, LLC | Pharmacy | 1260 Vine St, Suite 200, Salt Lake City, UT 84121-1700 | 2007-01-09 |
| 1104987312 | Depot Drug | Pharmacy | 1040 N 2200 W Ste 200, Salt Lake City, UT 84116-2929 | 2006-12-12 |
| 1659445187 | Jolley Comp and Specialty Pham | Pharmacy | 1702 S 1100 E, Salt Lake City, UT 84105-3424 | 2006-11-17 |
| 1932298528 | University of Utah | Pharmacy | 555 S Foothill Blvd, Suite 396, Salt Lake City, UT 84112-1106 | 2006-10-12 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84115 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.