NPIMap

Organization Active NPI

CD Pharmacy LLC

Doing business as Red Rock Pharmacy

  • Long Term Care Pharmacy
  • SLC, UT
National Provider Identifier
1386980944
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
8627028-1704 Issued in UT
Legal business name
CD PHARMACY LLC
Doing business as
Red Rock Pharmacy
Practice address
450 S 900 E Ste 150
SLC, UT 84102-2959
Phone
(801) 433-9500
Fax
(801) 433-9333
NPI assigned
Dec 28, 2012
Last updated
Oct 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Kenneth Norris
Title
Owner
Phone
(801) 433-9500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 8627028-1704 UT Primary
Managed Care Organization Pharmacy 3336M0003X

Addresses

Primary practice location

450 S 900 E Ste 150
SLC, UT 84102-2959

Mailing address

450 S 900 E
Ste 150
SLC, UT 84102-2981
Phone (801) 433-9500

Other names 1

  • Red Rock Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20140424002244 UT Part B Supplier - Pharmacy 0143453241 Practice locations: Salt Lake City, UT
O20201001001468 UT Part B Supplier - Independent Clinical Laboratory 0143453241 Practice locations: Salt Lake City, UT
O20220322000735 UT DME Supplier - Pharmacy 0143453241 Practice locations: Salt Lake City, UT

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2192873CD Pharmacy LLC450 S 900 E Ste 150, Salt Lake City, UT 84102Certificate of waiverSep 14, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Red Rock Pharmacy450 S 900 E, Salt Lake City, UT 84102-2959(801) 433-9500 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Mar 10, 2014

National Provider Directory

National Provider Directory
Tax ID family
CD Pharmacy LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

450 S 900 E
Ste 1
Salt Lake City, UT 84102
Phone (801) 433-9500

NPI Registry JSON

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

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1386980944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S 900 E",
            "address_2": "STE 150",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841022981",
            "telephone_number": "801-433-9500",
            "fax_number": "801-433-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S 900 E STE 150",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841022959",
            "telephone_number": "801-433-9500",
            "fax_number": "801-433-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CD PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-28",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-433-9500"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "UT",
            "license": "8627028-1704",
            "primary": true
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Rock Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.