NPIMap

Organization Active NPI

Wayne Community Health Center Pharmacy

  • Community/Retail Pharmacy
  • Bicknell, UT
National Provider Identifier
1376568188
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
4855620-1703 Issued in UT
Legal business name
WAYNE COMMUNITY HEALTH CENTER PHARMACY
Practice address
128 South 300 West
Bicknell, UT 84715-0303
Phone
(435) 425-3744
Fax
(435) 425-1139
NPI assigned
Jul 13, 2006
Last updated
Mar 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Authorized official

Name
Donavan Smith, RPH.NPI 1891791604
Title
Pharmacist
Phone
(435) 425-3744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 4855620-1703 UT Primary

Addresses

Primary practice location

128 South 300 West
Bicknell, UT 84715-0303

Mailing address

128 South 300 West
P.O. Box 303
Bicknell, UT 84715-0303
Phone (435) 425-3744

National Provider Directory

National Provider Directory
Tax ID family
Wayne Community HLTH CT7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1376568188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 SOUTH 300 WEST",
            "address_2": "P.O. BOX 303",
            "city": "BICKNELL",
            "state": "UT",
            "postal_code": "847150303",
            "telephone_number": "435-425-3744",
            "fax_number": "435-425-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 SOUTH 300 WEST",
            "city": "BICKNELL",
            "state": "UT",
            "postal_code": "847150303",
            "telephone_number": "435-425-3744",
            "fax_number": "435-425-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE COMMUNITY HEALTH CENTER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DONAVAN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "435-425-3744",
        "authorized_official_credential": "RPH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "4855620-1703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bicknell, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.