NPIMap

Organization Active NPI

Utah State University Student Health Center

  • Clinic Pharmacy
  • Logan, UT
National Provider Identifier
1487869111
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
122899-1703 Issued in UT
Legal business name
UTAH STATE UNIVERSITY STUDENT HEALTH CENTER
Practice address
850 E 1200 N
Logan, UT 84322-9100
Phone
(435) 797-1660
Fax
(435) 797-3585
NPI assigned
May 14, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. James W Davis, M.D.
Title
Executive Director
Phone
(435) 797-1660

Corporate family (same tax ID) 11

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

National Provider Directory

National Provider Directory
Tax ID family
Utah State University (12 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 122899-1703 UT Primary

Addresses

NPPES NPI Registry

Primary practice location

850 E 1200 N
Logan, UT 84322-9100

Mailing address

9100 Old Main HL
Logan, UT 84322-9100
Phone (435) 797-1660

Other names 1

NPPES NPI Registry
  • Student Health Center Pharmacy Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 24, 2014.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390521600000",
    "number": "1487869111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 OLD MAIN HL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843229100",
            "telephone_number": "435-797-1660",
            "fax_number": "435-797-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E 1200 N",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843229100",
            "telephone_number": "435-797-1660",
            "fax_number": "435-797-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH STATE UNIVERSITY STUDENT HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2014-01-24",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "435-797-1660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "UT",
            "license": "122899-1703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Student Health Center Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.