Select Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

9633146-1704 Issued in UT

Legal business name

SELECT PHARMACY LLC

Practice address

628 W 7250 S
Midvale, UT 84047-1060

Phone

(801) 849-1595

Fax

(801) 895-7450

NPI assigned

Nov 18, 2015

Organization subpart

No

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

Authorized official

Name

Roy Payne

Title

President

Phone

(801) 759-8981

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Select Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1154795854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 W 7250 S",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471060",
            "telephone_number": "801-849-1595",
            "fax_number": "801-895-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 W 7250 S",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471060",
            "telephone_number": "801-849-1595",
            "fax_number": "801-895-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-759-8981"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "UT",
            "license": "9633146-1704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157509",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Select Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Midvale, UT
• Providers in Midvale, UT by specialty
• Long Term Care Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.