NPIMap

Organization Active NPI

University of Utah

Doing business as Redwood Pharmacy

  • Community/Retail Pharmacy
  • Salt Lake City, UT
National Provider Identifier
1114016706
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
7098434-1703 Issued in UT
Legal business name
UNIVERSITY OF UTAH
Doing business as
Redwood Pharmacy
Practice address
1525 W 2100 S
Salt Lake City, UT 84119-1407
Phone
(801) 213-9950
Fax
(801) 213-9965
NPI assigned
Oct 12, 2006
Last updated
Mar 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Kellee K Howell, CPHT
Title
Pharmacy Business Operations Manage
Phone
(801) 587-6334

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 7098434-1703 UT Primary

Addresses

Primary practice location

1525 W 2100 S
Salt Lake City, UT 84119-1407

Mailing address

PO Box 841208
Los Angeles, CA 90084-1208
Phone (801) 587-6334

Other names 1

  • REDWOOD PHARMACY Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930043425 UT DME Supplier - Pharmacy 0749262665 Practice locations: Salt Lake City, UT
O20201021001587 UT Part B Supplier - Mass Immunization (Roster Biller Only) 0749262665 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salt Lake City, UT; Taylorsville, UT; Stansbury Park, UT; South Jordan, UT; Park City, UT; Orem, UT; Midvale, UT; Farmington, UT…

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
University of Utah Heal73 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Utah Hospitals and ClinicsSalt Lake City, UT, CCN 460009 Hospital 5% Or Greater Direct Ownership Interest Jun 17, 1966
University of UtahSalt Lake City, UT, CCN 46T009 Hospital 5% Or Greater Direct Ownership Interest Jun 17, 1966

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • University of Utah

    dba Huntsman Mental Health Institute

    • General Acute Care Hospital
    • Salt Lake City, UT
    • NPI 1487734976

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • University of Utah

    dba University Health Care Hospitals and Clinics

    • General Acute Care Hospital
    • Salt Lake City, UT
    • NPI 1588656870

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • University of Utah

    dba University Health Care

    • General Acute Care Hospital
    • Salt Lake City, UT
    • NPI 1699889576

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • University of Utah

    dba University Health Care Rehab Services

    • Rehabilitation Hospital
    • Salt Lake City, UT
    • NPI 1881708766

    5% Or Greater Direct Ownership Interest

    CMS ownership

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1114016706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841208",
            "telephone_number": "801-587-6334",
            "fax_number": "801-587-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W 2100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841191407",
            "telephone_number": "801-213-9950",
            "fax_number": "801-213-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "HOWELL",
        "authorized_official_first_name": "KELLEE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHARMACY BUSINESS OPERATIONS MANAGE",
        "authorized_official_telephone_number": "801-587-6334",
        "authorized_official_credential": "CPHT"
    },
    "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": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "7098434-1703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REDWOOD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "REDWOOD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.