Park City Market Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

6957464-1703 Issued in UT

Legal business name

PARK CITY MARKET INC

Practice address

1500 Snow Creek Dr
Park City, UT 84060-7506

Phone

(435) 645-7916

Fax

(435) 655-7019

NPI assigned

Sep 21, 2009

Organization subpart

No

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

Authorized official

Name

Michael Holm, RPH, MBA

Title

President

Phone

(435) 645-7139

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Market Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory Scott Holm, PHARMD

  • Pharmacist
  • Park City, UT
  • NPI 1225526361
  NPD
• Calvin Riley Ostler, PHARMD

  • Pharmacist
  • Park City, UT
  • NPI 1659212165
  NPD (past)

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362960000000",
    "number": "1083948210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26417",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841260417",
            "telephone_number": "801-978-8225",
            "fax_number": "801-978-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SNOW CREEK DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607506",
            "telephone_number": "435-645-7916",
            "fax_number": "435-655-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CITY MARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-21",
        "last_updated": "2013-03-11",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-645-7139",
        "authorized_official_credential": "RPH, MBA"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "6957464-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4611706",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870655253003",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Market Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Park City Fire Service District
• Park City Gynecology, LLC
• Park City Healthcare, PC
• Park City Imaging, Inc.
• Park City Internal Medicine - Pediatrics, LC
• Park City Medical Center
• Park City PDC PLLC
• Park City Pediatric Dentistry
• Park City Pediatric Dentistry
• Park City Surgery Center LLC

• Community/Retail Pharmacy in Park City, UT
• Providers in Park City, 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 Mar 11, 2013; 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.