NPIMap

Organization Active NPI

Utah CVS Pharmacy LLC

Doing business as CVS Pharmacy #17232

  • Pharmacy
  • West Jordan, UT
National Provider Identifier
1083798680
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
UTAH CVS PHARMACY LLC
Doing business as
CVS Pharmacy #17232
Practice address
7779 S Jordan Landing Blvd
West Jordan, UT 84084-1975
Phone
(801) 316-0050
Fax
(801) 316-0050
NPI assigned
Oct 24, 2006
Last updated
Nov 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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

Authorized official

Name
Susan Colbert
Title
Sr. Director, Payer Relations
Phone
(401) 770-2751

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X 9610050-1703 UT

Addresses

Primary practice location

7779 S Jordan Landing Blvd
West Jordan, UT 84084-1975

Mailing address

1 CVS Dr
Box 1075
Woonsocket, RI 02895-6146
Phone (401) 765-1500

Other identifiers 1

IdentifierTypeStateIssuer
2100902OtherPK

Other names 1

  • CVS Pharmacy #17232 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140611002183 UT Part B Supplier - Mass Immunization (Roster Biller Only) 4284861626 30 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salt Lake City, UT; Sandy, UT; South Jordan, UT; Spanish Fork, UT; Syracuse, UT; Taylorsville, UT; West Jordan, UT; West Valley City, UT…
O20161108000074 UT DME Supplier - Pharmacy 4284861626 Practice locations: West Jordan, UT

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
CVS Pharmacy #172327779 S Jordan Landing Blvd, West Jordan, UT 84084-1975(801) 316-0050 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urologic… Does not accept assignmentParticipating since Jan 1, 2025

National Provider Directory

National Provider Directory
Tax ID family
Utah CVS Pharmacy LLC33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7779 S Jordan Landing Blvd
West Jordan, UT 84084
Phone (801) 316-0050

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1083798680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "address_2": "BOX 1075",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146",
            "telephone_number": "401-765-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7779 S JORDAN LANDING BLVD",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840841975",
            "telephone_number": "801-316-0050",
            "fax_number": "801-316-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH CVS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PAYER RELATIONS",
        "authorized_official_telephone_number": "401-770-2751"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "9610050-1703",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2100902",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVS Pharmacy #17232",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.