NPIMap

Organization Active NPI

University of Utah

  • Community/Retail Pharmacy
  • South Jordan, UT
National Provider Identifier
1275838575
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
7824017-1703 Issued in UT
Legal business name
UNIVERSITY OF UTAH
Practice address
4696 Daybreak Rim Way
South Jordan, UT 84095-5129
Phone
(801) 213-4550
Fax
(801) 213-4555
NPI assigned
Jan 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Authorized official

Name
Michael Kelly
Title
Pharmacy SRV. Director
Phone
(801) 587-6325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 7824017-1703 UT Primary

Addresses

Primary practice location

4696 Daybreak Rim Way
South Jordan, UT 84095-5129

Mailing address

4696 Daybreak Rim Way
South Jordan, UT 84095-5129
Phone (801) 213-4550

Other identifiers 1

IdentifierTypeStateIssuer
4611922OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • South Jordan Daybreak Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bruce D Etringer PHD54 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

4696 W Daybreak Rim Way
South Jordan, UT 84009
Phone (801) 213-4500

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1275838575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4696 DAYBREAK RIM WAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955129",
            "telephone_number": "801-213-4550",
            "fax_number": "801-213-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4696 DAYBREAK RIM WAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955129",
            "telephone_number": "801-213-4550",
            "fax_number": "801-213-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-18",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PHARMACY SRV. DIRECTOR",
        "authorized_official_telephone_number": "801-587-6325"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "7824017-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4611922",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Jordan Daybreak Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.