MOUNTAINLANDS FAMILY PHARMACY (NPI# 1871812370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871812370 |
| Entity Type | Organization |
| Organization Name | MOUNTAINLANDS FAMILY PHARMACY |
| Other Organization Name | MOUNTAINLANDS FAMILY PHARMACY |
| Practice Address |
589 S State St Provo UT 84606-5056 |
| Practice Telephone | 8014292000 |
| Mailing Telephone | 8014292000 |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2020-08-04 |
| Authorized Official Name | TODD BAILEY (CEO) |
| Authorized Official Telephone | 8014292011 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
7630544-1703 | UT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4611821 | 01 |
| Other Name | Type Code |
|---|---|
| Mountainlands Family Pharmacy | Doing Business As Name - Organization |
| Street Address |
589 S STATE ST |
| City | PROVO |
| State | UT |
| Zip Code | 84606-5056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427075134 | Mountainlands Community Health Center, Inc | Dentist | 589 S State St, Provo, UT 84606-5056 | 2006-07-17 |
| 1144829946 | Mountainlands Community Health Center, Inc | Dentist | 589 S State St, Provo, UT 84606-5056 | 2020-10-22 |
| 1295347169 | Maria Dj Villagrana | Nurse Practitioner | 589 S State St, Provo, UT 84606-5056 | 2020-08-20 |
| 1932678307 | Sarah Gwendolyn Harmon Davis | Nurse Practitioner | 589 S State St, Provo, UT 84606-5056 | 2018-11-15 |
| 1003334525 | Kelly Marie Daly-wolfe | Physician Assistant | 589 S State St, Provo, UT 84606 | 2017-09-05 |
| 1497290555 | Elizabeth Anne Balle | Social Worker | 589 S State St, Provo, UT 84606-5056 | 2016-12-28 |
| 1639539521 | Leslie Divall | Midwife | 589 S State St, Provo, UT 84606-5056 | 2016-03-04 |
| 1871960823 | Verdon Reed Walker IIi | Physician Assistant | 589 S State St, Provo, UT 84606-5056 | 2015-08-25 |
| 1801223425 | Tyler David Sommer | Physician Assistant | 589 S State St, Provo, UT 84606-5056 | 2013-09-27 |
| 1902151954 | Stacy Ann Garnica | Nurse Practitioner | 589 S State St, Provo, UT 84606 | 2012-07-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935551 | Olivia Stiles | Specialist/Technologist | 200 E 515 N, Provo, UT 84606 | 2020-06-01 |
| 1417439076 | Quin Spencer Volpe | Counselor | 1035 E 560 N, Provo, UT 84606 | 2018-08-30 |
| 1700365434 | Hyunwook Lee | Specialist/Technologist | 1369 S 1500 E, Provo, UT 84606 | 2018-08-13 |
| 1598268930 | Victor Bert Arthur Moxley | Specialist | 290 N 300 E, Provo, UT 84606 | 2018-03-12 |
| 1184132623 | Academy Dental LLC | Advanced Practice Dental Therapist | 488 N 100 E St., Provo, UT 84606 | 2018-01-18 |
| 1720433485 | Sean Lamb | Counselor | 231 S. 100 E., Provo, UT 84606 | 2016-05-02 |
| 1508236795 | Forever Young Dentistry Pllc | Clinic/Center | 2335 S. State Street, Ste #200, Provo, UT 84606 | 2015-09-30 |
| 1558766014 | Nancy Huber | Physician Assistant | Mountainland Community Health Center, 529 South State Street, Provo, UT 84606 | 2014-10-27 |
| 1356778377 | Myrna Suzanne Gillis | Marriage & Family Therapist | 1726 Buckley Drive, Provo, UT 84606 | 2013-10-04 |
| 1558651067 | Melissa Anne Mccreary | Counselor | 151 S.state St. University Ave., Ste 1400, Provo, UT 84606 | 2011-04-18 |
| Find all providers in zip 84606 | ||||
| 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 |
|---|---|---|---|---|
| 1659859965 | Bettercare Family Pharmacy LLC | Pharmacy | 545 Columbia Ln, Provo, UT 84604-2450 | 2018-07-30 |
| 1467961995 | Meds In Motion, LLC | Pharmacy | 1055 N 300 W Ste 201a, Provo, UT 84604-3374 | 2017-09-27 |
| 1427381714 | Associated Fresh Markets Inc | Pharmacy | 560 W Center St, Provo, UT 84601-4276 | 2009-09-17 |
| 1083723217 | Maceys Inc | Pharmacy | 1402 N State St, Provo, UT 84604-2415 | 2006-08-30 |
| 1174552848 | Super Save Markets | Pharmacy | 655 E 300 S, Provo, UT 84606-4962 | 2006-07-03 |
| 1861815110 | Mountainlands Family Pharmacy - Wasatch | Pharmacy | 750 N 200 W, Suite 201, Provo, UT 84601-3539 | 2014-01-22 |
| 1578831699 | Walgreens | Pharmacy | 1315 N State St, Provo, UT 84604-2416 | 2011-12-03 |
| 1689849606 | Walgreen Co | Pharmacy | 1315 N State St, Provo, UT 84604-2416 | 2008-04-30 |
| 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 |
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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.