STATE OF UTAH (NPI# 1972870517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972870517 |
| Entity Type | Organization |
| Organization Name | STATE OF UTAH |
| Other Organization Name | UTAH STATE PRISON PHARMACY |
| Practice Address |
14425 Bitterbrush Ln Draper UT 84020-9501 |
| Mailing Address |
Po Box 250 Draper UT 84020-0250 |
| Practice Telephone | 8015767116 |
| Practice Fax Number | 8015767059 |
| Mailing Telephone | 8015767116 |
| Mailing Fax Number | 8015767059 |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |
| Authorized Official Name | BRYAN DESPAIN (PHARMACIST) |
| Authorized Official Telephone | 8015767117 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
1228741704 | UT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4612152 | 01 |
| Other Name | Type Code |
|---|---|
| Utah State Prison Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679964597 | State of Utah | Clinical Medical Laboratory | 4431 S Constitution Blvd, Taylorsville, UT 84129-8600 | 2015-02-13 |
| 1699878942 | State of Utah | Public Health or Welfare | 44 N Mario Cappeci Drive, Salt Lake City, UT 84114 | 2006-09-05 |
| 1811978620 | State of Utah | Psychiatric Hospital | 1300 E Center St, Provo, UT 84606-3554 | 2005-11-09 |
| Street Address |
14425 BITTERBRUSH LN |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-9501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679732382 | Richard M Garden | Preventive Medicine | 14425 Bitterbrush Ln, Draper, UT 84020-9501 | 2008-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; 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 |
|---|---|---|---|---|
| 1124084835 | Icare Pharmacy | Pharmacy | 109 W.gentile Street, Layton, UT 84041 | 2006-04-21 |
| 1013354067 | Mckay-dee Hospital | Pharmacy | 4401 Harrison Blvd, Ogden, UT 84403-3195 | 2013-05-31 |
| 1609110816 | Ihc Health Services, Inc. | Pharmacy | 1000 N Main St, Richfield, UT 84701-1857 | 2012-11-15 |
| 1154674653 | American Fork Hospital | Pharmacy | 170 N 1100 E, American Fork, UT 84003-2096 | 2012-10-22 |
| 1225389810 | Park City Medical Center | Pharmacy | 900 Round Valley Dr, Park City, UT 84060-7552 | 2012-09-24 |
| 1316218449 | Utah State Hospital Pharmacy | Pharmacy | 1300 East Center Street, Provo, UT 84606-3554 | 2012-01-20 |
| 1396935375 | Utah Valley Specialty Hospital (pharmacy) | Pharmacy | 306 River Bend Ln, Provo, UT 84604-5625 | 2007-07-26 |
| 1942425475 | Castleview Hospital | Pharmacy | 300 N Hospital Dr, Price, UT 84501-4218 | 2007-04-17 |
| 1922160043 | Moab Valley Healthcare, Inc. | Pharmacy | 450 Williams Way, Moab, UT 84532-2065 | 2006-12-14 |
| 1396835229 | Univ Ut Neurophsychiatric Inst | Pharmacy | 501 Chipeta Way, Salt Lake City, UT 84108-1222 | 2006-10-13 |
| Find all providers with the same taxonomy | ||||
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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.