Eco Pharmacy of Salt Lake City 1 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

9301773-1703 Issued in UT

Legal business name

ECO PHARMACY OF SALT LAKE CITY 1 LLC

Doing business as

Eco Pharmacy of Salt Lake City

Practice address

12523 S Creek Meadow Dr
Riverton, UT 84065-7291

Phone

(801) 254-6111

Fax

(801) 251-6226

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

Jasmeet Singh

Title

Owner, Ao

Phone

(832) 859-9523

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Eco Pharmacy of Salt Lake City Doing business as

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

{
    "created_epoch": "1447027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1649643909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12523 S CREEK MEADOW DR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657291",
            "telephone_number": "801-254-6111",
            "fax_number": "801-251-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12523 S CREEK MEADOW DR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657291",
            "telephone_number": "801-254-6111",
            "fax_number": "801-251-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECO PHARMACY OF SALT LAKE CITY 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-09",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "JASMEET",
        "authorized_official_title_or_position": "OWNER,  AO",
        "authorized_official_telephone_number": "832-859-9523"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "9301773-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155228",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eco Pharmacy of Salt Lake City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• J Timothy Duffy, MD
• Robert Gene Duncombe, SSW, M.S.
• Michael Durbano
• Zachary Thomas Duvall, MSW, CSW
• Katelyn Taylor Earnest, CCC-SLP
• Janet Benavidez Eddy, M.D.
• Sean Frederick Edmunds, MD
• Robert Philip Edwards, MD
• Tammy Edwards
• Dan Egbert, D.C.

• Community/Retail Pharmacy in Riverton, UT
• Providers in Riverton, 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 May 27, 2016; 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.