NPIMap

Organization Active NPI

Diabetes Specialty Center

  • Pharmacy
  • Salt Lake City, UT
National Provider Identifier
1033199666
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
8021342-1703 Issued in UT
Legal business name
DIABETES SPECIALTY CENTER
Practice address
3744 Second Street
Ste a
Salt Lake City, UT 84115
Phone
(801) 268-9699
Fax
(888) 321-7719
NPI assigned
Jan 19, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kim E Doman
Title
Controller
Phone
(801) 263-5442

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5738699-1703 UT
Pharmacy 333600000X 8021342-1703 UT Primary
Community/Retail Pharmacy 3336C0003X 5738699-1703 UT

Addresses

Primary practice location

3744 Second Street
Ste a
Salt Lake City, UT 84115

Mailing address

3793 South State Street
Salt Lake City, UT 84115-4828
Phone (801) 268-9699

National Provider Directory

National Provider Directory
Tax ID family
Diabetes Specialty Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1033199666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3793 SOUTH STATE STREET",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841154828",
            "telephone_number": "801-268-9699",
            "fax_number": "801-268-9929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3744 SECOND STREET",
            "address_2": "STE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84115",
            "telephone_number": "801-268-9699",
            "fax_number": "888-321-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES SPECIALTY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DOMAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "801-263-5442",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "UT",
            "license": "5738699-1703",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "UT",
            "license": "8021342-1703",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "5738699-1703",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.