Organization Active NPI

University of Utah

Doing business as Hospital Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Salt Lake City, UT
National Provider Identifier
1427148402
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
73467901703 Issued in UT
Legal business name
UNIVERSITY OF UTAH
Doing business as
Hospital Outpatient Pharmacy
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 581-2276
Fax
(801) 585-2306
NPI assigned
Oct 13, 2006
Last updated
Mar 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Kellee K Howell, CPHT
Title
Business Operations Manager
Phone
(801) 587-6334

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 73467901703 UT Primary

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0001

Mailing address

PO Box 841208
Los Angeles, CA 90084-1208
Phone (801) 587-6334

Other identifiers 2

IdentifierTypeStateIssuer
2107669OtherPK
4602757OtherNCPDP

Other names 1

  • HOSPITAL OUTPATIENT PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930045591 UT DME Supplier - Pharmacy 0749262665 Practice locations: Salt Lake City, UT
O20201021001587 UT Part B Supplier - Mass Immunization (Roster Biller Only) 0749262665 13 other NPIs on this enrollment
Practice locations: Salt Lake City, UT; Taylorsville, UT; Stansbury Park, UT; South Jordan, UT; Park City, UT; Orem, UT; Midvale, UT; Farmington, UT…

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Univ of Utah Outpatient Pharmacy50 N Medical Dr, Salt Lake City, UT 84132-0001(801) 581-2276 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Oct 16, 2018

National Provider Directory

National Provider Directory
Tax ID family
Division of Artificial54 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Utah Hospitals and ClinicsSalt Lake City, UT, CCN 460009 Hospital 5% Or Greater Direct Ownership Interest Jun 17, 1966
University of UtahSalt Lake City, UT, CCN 46T009 Hospital 5% Or Greater Direct Ownership Interest Jun 17, 1966

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1427148402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841208",
            "telephone_number": "801-587-6334",
            "fax_number": "801-587-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2276",
            "fax_number": "801-585-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "HOWELL",
        "authorized_official_first_name": "KELLEE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS MANAGER",
        "authorized_official_telephone_number": "801-587-6334",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "73467901703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2107669",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4602757",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOSPITAL OUTPATIENT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HOSPITAL OUTPATIENT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.