Active NPI
HRX Pharmacy LLC
- Community/Retail Pharmacy
- Salt Lake City, UT
National Provider Identifier
1417400797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 9871861-1703
- Legal business name
- HRX PHARMACY LLC
- Practice address
- 4227 S Highland Dr
Suite 6
Salt Lake City, UT 84124-2645 - Phone
- (801) 553-3426
- Fax
- (801) 553-2540
- NPI assigned
- Aug 3, 2016
- Last updated
- Sep 20, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cody Walker, PHARMD
- Title
- Pharmacist
- Phone
- (801) 898-7132
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 9871861-1703 | UT | Primary |
Addresses
Primary practice location
4227 S Highland Dr
Suite 6
Salt Lake City, UT 84124-2645
Mailing address
4227 S Highland Dr
Suite 6
Salt Lake City, UT 84124-2645
Phone (801) 553-3426
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210219001605 | UT | Part B Supplier - Mass Immunization (Roster Biller Only) | 0345655585 | Practice locations: Salt Lake City, UT |
National Provider Directory
National Provider Directory- Tax ID family
- HRX Pharmacy LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacy
- Holladay, UT
- NPI 1619755436
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470182400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695168000000",
"number": "1417400797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4227 S HIGHLAND DR",
"address_2": "SUITE 6",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841242645",
"telephone_number": "801-553-3426",
"fax_number": "801-553-2540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4227 S HIGHLAND DR",
"address_2": "SUITE 6",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841242645",
"telephone_number": "801-553-3426",
"fax_number": "801-553-2540"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HRX PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-08-03",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A",
"authorized_official_last_name": "WALKER",
"authorized_official_first_name": "CODY",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "801-898-7132",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "UT",
"license": "9871861-1703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.