NPIMap

Organization Active NPI

Brigham Young University

  • Clinic Pharmacy
  • Provo, UT
National Provider Identifier
1467584300
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
359430-1703 Issued in UT
Legal business name
BRIGHAM YOUNG UNIVERSITY
Doing business as
BRIGHAM YOUNG UNIVERSITY PHARMACY
Practice address
1750 N Wymount Terrace Dr
Provo, UT 84604-8600
Phone
(801) 422-5171
Fax
(801) 422-0812
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Authorized official

Name
James C Averett, RPH
Title
Director of Pharmacy
Phone
(801) 422-9701

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 3594301703 UT
Clinic Pharmacy 3336C0002X 359430-1703 UT Primary

Addresses

Primary practice location

1750 N Wymount Terrace Dr
Provo, UT 84604-8600

Mailing address

1750 N Wymount Terrace Dr
Provo, UT 84604-8600
Phone (801) 422-5171

Other identifiers 1

IdentifierTypeStateIssuer
4601971OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • BRIGHAM YOUNG UNIVERSITY PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brigham Young University7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1467584300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 N WYMOUNT TERRACE DR",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846048600",
            "telephone_number": "801-422-5171",
            "fax_number": "801-422-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 N WYMOUNT TERRACE DR",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846048600",
            "telephone_number": "801-422-5171",
            "fax_number": "801-422-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHAM YOUNG UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "AVERETT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "801-422-9701",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "UT",
            "license": "3594301703",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "UT",
            "license": "359430-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4601971",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIGHAM YOUNG UNIVERSITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.