Organization Active NPI

Terrace Pharmacy

  • Community/Retail Pharmacy
  • Ogden, UT
National Provider Identifier
1295829976
Registry record updated May 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
7872230-8913 Issued in UT
Legal business name
TERRACE PHARMACY
Practice address
5167 Adams Ave
#B
Ogden, UT 84405-4522
Phone
(801) 479-9645
Fax
(801) 475-6404
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2010

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

Authorized official

Name
Alan V Winter
Title
Owner/Pharmacist
Phone
(801) 479-9645

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 7572230-1703 UT
Community/Retail Pharmacy 3336C0003X 7872230-8913 UT Primary

Addresses

Primary practice location

5167 Adams Ave
#B
Ogden, UT 84405-4522

Mailing address

5167 Adams Ave
#B
Ogden, UT 84405-4522
Phone (801) 479-9645

Other identifiers 1

IdentifierTypeStateIssuer
528962785009MedicaidUT

National Provider Directory

National Provider Directory

Locations

5167 Adams Ave
Ste B
Ogden, UT 84405
Phone (801) 479-9645

5167 Adams Ave
#B
Ogden, UT 84405
Phone (801) 479-9645

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1295829976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5167 ADAMS AVE",
            "address_2": "#B",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054522",
            "telephone_number": "801-479-9645",
            "fax_number": "801-475-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5167 ADAMS AVE",
            "address_2": "#B",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054522",
            "telephone_number": "801-479-9645",
            "fax_number": "801-475-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRACE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "WINTER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "801-479-9645"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "7572230-1703",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "7872230-8913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528962785009",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.