Gunnison Family Pharmacy & Floral Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8357604-1703 Issued in UT

Legal business name

GUNNISON FAMILY PHARMACY & FLORAL INC

Doing business as

Gunnison Family Pharmacy & Floral

Practice address

77 South Main Street
Gunninson, UT 84634

Phone

(435) 528-3455

Fax

(435) 528-3776

NPI assigned

Jan 15, 2014

Last updated

Apr 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Courtney Adam Hardy, PHARMDNPI 1104412113

Title

Pic

Phone

(435) 528-3455

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• Gunnison Family Pharmacy & Floral Doing business as
• Family Pharmacy LLC. Former legal business name

Medicare fee-for-service enrollment

Enrolled in UT2 enrollments

Enrollment records 2

Tax ID family

Family Pharmacy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Gunnison Family Pharmacy & Floral Inc

  dba Gunnison Family Pharmacy and Floral

  • Long Term Care Pharmacy
  • Gunnison, UT
  • NPI 1386106896
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Courtney Adam Hardy, PHARMD

  • Pharmacist
  • Gunnison, UT
  • NPI 1104412113
  NPD Authorized official

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1063834760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789",
            "city": "GUNNISON",
            "state": "UT",
            "postal_code": "846340789",
            "telephone_number": "435-528-3455",
            "fax_number": "435-528-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 SOUTH MAIN STREET",
            "city": "GUNNINSON",
            "state": "UT",
            "postal_code": "84634",
            "telephone_number": "435-528-3455",
            "fax_number": "435-528-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNNISON FAMILY PHARMACY & FLORAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "435-528-3455",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "8357604-1703",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "646037165001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143922",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gunnison Family Pharmacy & Floral",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gunnison Family Pharmacy & Floral",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Pharmacy LLC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.