Park Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PARK PHARMACY INC

Practice address

1591 W Center St
Provo, UT 84601-3936

Phone

(801) 373-6043

Fax

(801) 373-6253

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Ellis Lewis

Title

President

Phone

(801) 373-6043

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1215948708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 W CENTER ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846013936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 W CENTER ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846013936",
            "telephone_number": "801-373-6043",
            "fax_number": "801-373-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ELLIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-373-6043"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "UT",
            "license": "1333221703",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4607555",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Pansing, MD
• Angelica Pantoja
• Leia Catherine Papenfuss
• Claudia Dayana Paradis
• Ian Parham
• David A Park, M.D., D.D.S.
• Jaeyeon Park
• Ladawn Marie Park, SSW
• Morgan Park
• Natalie Park, FNP-C

• Community/Retail Pharmacy in Provo, UT
• Providers in Provo, 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 Sep 11, 2025; 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.