Mythic RX

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

MYTHIC RX

Practice address

3920 S 1100 E Ste 110
Millcreek, UT 84124-1213

Phone

(801) 590-8345

Fax

(385) 327-0105

NPI assigned

Jul 19, 2024

Organization subpart

No

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

Authorized official

Name

Sara Dewitt, PHARMD

Title

Pharmacist

Phone

(801) 637-9967

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1184462368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 S 1100 E STE 110",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841241213",
            "telephone_number": "801-590-8345",
            "fax_number": "385-327-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 S 1100 E STE 110",
            "city": "MILLCREEK",
            "state": "UT",
            "postal_code": "841241213",
            "telephone_number": "801-590-8345",
            "fax_number": "385-327-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYTHIC RX",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "DEWITT",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "801-637-9967",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julare Ann Morris, CSW
• Autumn Mortensen, RBT
• Emily Mortensen
• Lucy Mower, RD
• Jennifer Murphy, M.D.
• Elviera Marie Nakajima
• Todd Robert Nelson, MD
• Newline Business Group LLC
• Northern Utah Healthcare Corporation
• Allison Blaine Oconnor

• Compounding Pharmacy in Millcreek, UT
• Providers in Millcreek, UT by specialty
• Compounding Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.