Medipharm

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

License

375923-1704 Issued in UT

Legal business name

MEDIPHARM

Practice address

1260 Vine St
Salt Lake City, UT 84121-1700

Phone

(801) 733-9902

Fax

(801) 733-9998

NPI assigned

Apr 24, 2007

Last updated

Aug 14, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Dunn

Title

V.P.

Phone

(801) 839-9079

Specialties & licenses 6

Addresses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1245459627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71428",
            "city": "COTTONWOOD",
            "state": "UT",
            "postal_code": "841710428",
            "telephone_number": "801-733-9902",
            "fax_number": "801-733-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 VINE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211700",
            "telephone_number": "801-733-9902",
            "fax_number": "801-733-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIPHARM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "V.P.",
        "authorized_official_telephone_number": "801-839-9079"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "UT",
            "license": "9680-07",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "UT",
            "license": "375923-1704",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "375923-1704",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "UT",
            "license": "375923-1704",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "UT",
            "license": "375923-1704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medicruiser, LLC
• Anthony David Medina
• Janet Medina
• Lisa Ann Medina
• Maryanne Medina
• Jon Medler
• Walter Scott Edwards Medlin, M.D.
• Theodore W. Medling, MD
• Morris Medlyn
• Medone DME, LLC

• Specialty Pharmacy in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Specialty Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.