GREEN RIVER MEDICAL CENTER, INC. (NPI# 1689134868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689134868 |
| Entity Type | Organization |
| Organization Name | GREEN RIVER MEDICAL CENTER, INC. |
| Practice Address |
585 West Main Street Green River UT 84525 |
| Mailing Address |
Po Box 417 Green River UT 84525-0417 |
| Practice Telephone | 4355643434 |
| Practice Fax Number | 4355643214 |
| Mailing Telephone | 4355643434 |
| Mailing Fax Number | 4355643214 |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2019-03-22 |
| Authorized Official Name | PAULA JEAN DUNHAM (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4355640213 |
| Is Organization Subpart | Y |
| Parent Organization Name | GREEN RIVER MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | UTAH DOPL PHARMACY CLASS A LICENSE | 11065988-1703 | 01 |
| UT | 261QF0400X | 05 | |
| DEA CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE | FG8211512 | 01 | |
| UT | UTAH DOPL DISPENSING CONTROLLED SUBSTANCE LICENSE | 11065988-8913 | 01 |
| Other Name | Type Code |
|---|---|
| Green River Medical Center Pharmacy | Doing Business As Name - Organization |
| Street Address |
585 WEST MAIN STREET |
| City | GREEN RIVER |
| State | UT |
| Zip Code | 84525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326081084 | Kim Thyrill Mcfarlane | Physician Assistant | 585 West Main Street, Green River, UT 84525-0417 | 2006-06-13 |
| 1841540077 | Green River Medical Center Inc | Pharmacy | 585 West Main Street, Green River, UT 84525 | 2012-09-14 |
| 1821243684 | Shannon Taylor Thurston | Physician Assistant | 585 West Main Street, Green River, UT 84525 | 2008-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871061929 | Zackery N Taylor | Pharmacist | 585 W Main St, Green River, UT 84525 | 2018-11-07 |
| 1861962912 | Tyler J Rundell | Physician Assistant | 585 Main St, Green River, UT 84525 | 2018-12-03 |
| 1497840987 | Loye West | Physician Assistant | 305 West Main Street, Green River, UT 84525 | 2006-10-03 |
| 1043648108 | Amber Dawn Fowler | Counselor | 585 W. Main Street, Green River, UT 84525-0417 | 2013-10-28 |
| 1942317722 | Green River Medical Center Inc | Clinic/Center | 585 West Main St., Box 417, Green River, UT 84525-0417 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440443 | Jeanette Paladino | Case Manager/Care Coordinator | 360 Greasewood St, Green River, WY 82935-4722 | 2020-09-04 |
| 1760094411 | Shannon Christine Miller | Respite Care | 1750 New Mexico St, Green River, WY 82935-6252 | 2020-08-22 |
| 1467060301 | Roy Allen Lloyd | Case Management | 345 Anvil Dr Apt B, Green River, WY 82935-5487 | 2020-07-16 |
| 1205474160 | Matthew Gelston Herron | Case Manager/Care Coordinator | 700 Shoshone Ave Unit 26, Green River, WY 82935-5558 | 2019-12-11 |
| 1841854544 | Hilary Violet Hollihan Leavitt | Case Manager/Care Coordinator | 2030 Wyoming Dr, Green River, WY 82935-5851 | 2019-04-28 |
| 1427528488 | Richard Percifield | Counselor | 400 N 1st East St Ste 107a, Green River, WY 82935-4247 | 2018-12-03 |
| 1437660131 | Jennifer Ann Brown | Speech-Language Pathologist | 215 Maple Cir, Green River, WY 82935-4765 | 2017-10-20 |
| 1306376975 | Nicholas Henry Hastert | Physical Therapist | 330 Upland Way, Green River, WY 82935 | 2017-06-15 |
| 1073054508 | Jodie S Hix | Physical Therapy Assistant | 1715 Hitching Post Drive, Green River, WY 82935-6600 | 2017-03-16 |
| 1376089581 | Complete Chiropractics LLC | Chiropractor | 170 Commerce Dr Ste A, Green River, WY 82935-6156 | 2017-01-11 |
| Find all providers in GREEN RIVER | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851935688 | K-pack Pharmacy | Pharmacy | 170 Commerce Dr Ste B, Green River, WY 82935-6156 | 2019-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292167 | 3bc Incorporated | Pharmacy | 435 North Gateway Drive #802, Providence, UT 84332 | 2020-10-09 |
| 1598371973 | Mountain West Medicine Inc. | Pharmacy | 1551 Renaissance Towne Dr Ste 104, Bountiful, UT 84010-7682 | 2020-09-21 |
| 1518577741 | Black Panda LLC | Pharmacy | 2507 S State St, Salt Lake City, UT 84115-3109 | 2020-08-03 |
| 1235751900 | Roe Rx Inc | Pharmacy | 145 S 3000 W, West Point, UT 84015 | 2020-05-15 |
| 1023637675 | Santaquin Market, Inc. | Pharmacy | 110 N. 400 E., Santaquin, UT 84655 | 2020-04-14 |
| 1891345237 | Strive Pharmacy Utah 1 LLC | Pharmacy | 8928 S State St, Sandy, UT 84070-2246 | 2019-09-17 |
| 1336705755 | Bear Lake Community Health Center | Pharmacy | 517 W 100 N Ste 210, Providence, UT 84332-9826 | 2019-05-10 |
| 1912470246 | Ridley's Family Markets Inc | Pharmacy | 74 S 100 E, Tremonton, UT 84337-1606 | 2019-01-09 |
| 1437620762 | Pthl LLC | Pharmacy | 1890 Bonanza Dr Ste 107, Park City, UT 84060-7217 | 2018-12-16 |
| 1093285785 | Richfield Community Pharmacy LLC | Pharmacy | 440 S Main St Ste B, Richfield, UT 84701-2855 | 2018-11-26 |
| Find all providers with the same taxonomy | ||||
| City | GREEN RIVER |
| Zip Code | 84525 |
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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.