Market Fresh, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

95084881-1703 Issued in UT

Legal business name

MARKET FRESH, INC

Practice address

475 S Main St
Ephraim, UT 84627-4017

Phone

(435) 283-0340

Fax

(435) 283-0341

NPI assigned

Nov 9, 2015

Organization subpart

No

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

Authorized official

Name

Tyler Merrill

Title

President

Phone

(435) 851-0261

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ephraim Market Fresh Pharmacy Doing business as

Tax ID family

Ephraim Market Fresh 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.

• Market Fresh Inc

  • Community/Retail Pharmacy
  • Ephraim, UT
  • NPI 1215300660
  NPD tax ID

Locations

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1548633837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 S MAIN ST",
            "city": "EPHRAIM",
            "state": "UT",
            "postal_code": "846274017",
            "telephone_number": "435-283-0340",
            "fax_number": "435-283-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S MAIN ST",
            "city": "EPHRAIM",
            "state": "UT",
            "postal_code": "846274017",
            "telephone_number": "435-283-0340",
            "fax_number": "435-283-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARKET FRESH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-09",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "MERRILL",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-851-0261"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "95084881-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154991",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ephraim Market Fresh Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cheryl Luthy
• Jean Marsee Macdonald
• Kallie Kay Madsen
• Nicole Lavonne Malstrom
• Market Fresh Inc
• Judy Martinez
• Christian Matthews
• Jenny Beth Maurer, ACMHC
• Linda S Nielson MC Kenna
• Jennifer McIff

• Community/Retail Pharmacy in Ephraim, UT
• Providers in Ephraim, UT by specialty
• Community/Retail Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.