Organization Active NPI

HRX Pharmacy LLC

  • Community/Retail Pharmacy
  • Salt Lake City, UT
National Provider Identifier
1417400797
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
9871861-1703 Issued in UT
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, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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 LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

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.

Verify at the official NPI Registry.