Crystal Health Solutions Michigan LLC

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

Legal business name

CRYSTAL HEALTH SOLUTIONS MICHIGAN LLC

Practice address

160 Cutler Dr Ste 300
North Salt Lake, UT 84054-2967

Phone

(801) 854-7347

NPI assigned

Dec 22, 2025

Last updated

Dec 22, 2025By 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

Jacob C Moench

Title

Chief Executive Officer

Phone

(385) 368-6377

Specialties & licenses 1

Addresses

Tax ID family

Crystal Health Solutions Michigan LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Crystal Health Solutions Michigan LLC

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • North Salt Lake, UT
  • NPI 1912763517
  NPD tax ID

Locations

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

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1396600342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 N MAIN ST STE 220",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840412231",
            "telephone_number": "801-854-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CUTLER DR STE 300",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840542967",
            "telephone_number": "801-854-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL HEALTH SOLUTIONS MICHIGAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A",
        "authorized_official_last_name": "MOENCH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "385-368-6377"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dale Clifford
• Melou Stewart Cline, MA, SCMT, MT-BC/OTHE
• Lauren Maley Corona, RN
• Kimberly Anne Cozzens
• Michelle Earl Cruson, RPH
• Crystal Health Solutions Michigan LLC
• Elizabeth Crystal, BCBA LBA
• Brynli Shay Davis
• Shauniell Dearing, DDS
• Kimberly Hunt Delis, PHARMD

• Mail Order Pharmacy in North Salt Lake, UT
• Providers in North Salt Lake, UT by specialty
• Mail Order Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.