Diversified Professional Company

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

DIVERSIFIED PROFESSIONAL COMPANY

Practice address

1159 E 12TH Street
Ogden, UT 84404-5144

Phone

(801) 334-3190

Fax

(801) 334-3193

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary Lynn Bailey, RPH

Title

President

Phone

(801) 334-3190

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Canyon View Pharmacy Doing business as

Tax ID family

Canyon View 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.

• Diversified Professional Company

  • Community/Retail Pharmacy
  • Ogden, UT
  • NPI 1396827077
  NPD tax ID

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487736161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 E 12TH STREET",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045144",
            "telephone_number": "801-334-3190",
            "fax_number": "801-334-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 E 12TH STREET",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844045144",
            "telephone_number": "801-334-3190",
            "fax_number": "801-334-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED PROFESSIONAL COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-334-3190",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870218488006",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon View Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brett Ronald Dille, PA-C
• Kim Dinh-Nguyen
• Austin Paul Dinkel, DO
• Patricia Ann Dirks
• Diversified Professional Company
• Nicole Dixon
• Pegah Christine Dixon, A.P.R.N., W.H.N.P.
• Kylia Dobson
• Parker Stringham Dobson, MD
• Shayley Rae Dockstader, FNP-BC

• Compounding Pharmacy in Ogden, UT
• Providers in Ogden, UT by specialty
• Compounding Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.