Medsource RX Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

7609917-1703 Issued in UT

Legal business name

MEDSOURCE RX PHARMACY LLC

Doing business as

Medsource RX Pharmacy

Practice address

9883 S 500 W
Sandy, UT 84070-2561

Phone

(801) 727-1979

Fax

(855) 332-9272

NPI assigned

Mar 16, 2010

Organization subpart

No

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

Authorized official

Name

Sahily Paoline

Title

Pic

Phone

(888) 702-2195

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medsource RX Pharmacy Doing business as

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381449600000",
    "number": "1063736304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9883 S 500 W",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702561",
            "telephone_number": "801-727-0080",
            "fax_number": "855-332-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9883 S 500 W",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702561",
            "telephone_number": "801-727-1979",
            "fax_number": "855-332-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSOURCE RX PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-16",
        "last_updated": "2013-10-11",
        "status": "A",
        "authorized_official_last_name": "PAOLINE",
        "authorized_official_first_name": "SAHILY",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "888-702-2195"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "7609917-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2123919",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medsource RX Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meds for Vets
• Meds for Vets LLC (Meds for Vets)
• Medsource Inc.
• Medsource Medical, LLC (Ingram Medical)
• Medsource Mobility LLC (Aamco Medical)
• Megan Komatsu Inc.
• Dzenis Mehinovic, CRNA
• Alexus Jenet Melgoza
• David Todd Menssen, PHARMD
• John Rizzotte Merendino, MD

• Community/Retail Pharmacy in Sandy, UT
• Providers in Sandy, UT by specialty
• Community/Retail Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; 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.