NPIMap

Organization Active NPI

Med Quest Pharmacy

  • Compounding Pharmacy
  • North Salt Lake, UT
National Provider Identifier
1396787693
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
58722991703 Issued in UT
Legal business name
MED QUEST PHARMACY
Doing business as
Medquest Pharmacy
Practice address
669 W 900 N
North Salt Lake, UT 84054-2602
Phone
(801) 294-1400
Fax
(801) 294-1401
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Authorized official

Name
Jacque Butler
Title
Owner President
Phone
(801) 294-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X 58722991703 UT Primary

Addresses

Primary practice location

669 W 900 N
North Salt Lake, UT 84054-2602

Mailing address

669 W 900 N
North Salt Lake, UT 84054-2602
Phone (801) 294-1400

Other identifiers 1

IdentifierTypeStateIssuer
2100232OtherPK

Other names 1

  • MEDQUEST PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Med Quest Pharmacy2 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.

Locations

669 W 900 N
North Salt Lake, UT 84054
Phone (801) 294-1400

Practitioners & affiliated clinicians

Practitioners 12

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": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1396787693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 W 900 N",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840542602",
            "telephone_number": "801-294-1400",
            "fax_number": "801-294-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 W 900 N",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840542602",
            "telephone_number": "801-294-1400",
            "fax_number": "801-294-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED QUEST PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "JACQUE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "801-294-1400"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "UT",
            "license": "58722991703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2100232",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDQUEST PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Salt Lake, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.