Smith Drug Company of Pleasant Grove

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0089917035 Issued in UT

Legal business name

SMITH DRUG COMPANY OF PLEASANT GROVE

Practice address

10 S Main St
Pleasant GRV, UT 84062-2630

Phone

(801) 785-3221

NPI assigned

Jul 4, 2006

Last updated

Aug 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kristine Pence, CPHT

Title

Owner

Phone

(801) 785-3221

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1588694228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S MAIN ST",
            "city": "PLEASANT GRV",
            "state": "UT",
            "postal_code": "840622630",
            "telephone_number": "801-785-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S MAIN ST",
            "city": "PLEASANT GRV",
            "state": "UT",
            "postal_code": "840622630",
            "telephone_number": "801-785-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH DRUG COMPANY OF PLEASANT GROVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "PENCE",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-785-3221",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "0089917035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP PROVIDER NUMBER",
            "identifier": "4600664",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.