Mt Nebo Thrift Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8963467-1703 Issued in UT

Legal business name

MT NEBO THRIFT CORP

Practice address

965 N Main St
Nephi, UT 84648

Phone

(435) 623-2183

Fax

(435) 623-4237

NPI assigned

Mar 21, 2014

Organization subpart

No

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

Authorized official

Name

Harold Measom

Title

RX Supervisor

Phone

(801) 465-2347

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MT NEBO PHARMACY Doing business as

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": "1395360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529280000000",
    "number": "1649697244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 N MAIN ST",
            "city": "NEPHI",
            "state": "UT",
            "postal_code": "846481003",
            "telephone_number": "435-623-2183",
            "fax_number": "435-623-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 N MAIN ST",
            "city": "NEPHI",
            "state": "UT",
            "postal_code": "84648",
            "telephone_number": "435-623-2183",
            "fax_number": "435-623-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT NEBO THRIFT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-21",
        "last_updated": "2018-06-18",
        "status": "A",
        "authorized_official_last_name": "MEASOM",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_title_or_position": "RX SUPERVISOR",
        "authorized_official_telephone_number": "801-465-2347"
    },
    "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": "8963467-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649697244",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2145208",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MT NEBO PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MT NEBO PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler Nathan Memmott, CRNA
• Shaunna Meredith
• McKay Faith Meyer
• Ronald George Mortensen, QMRP/TRS
• Mt Nebo Anesthesia Associates LLC
• My Hearing Centers, LLC
• Nebo Vision Inc.
• Nephi Professional Pharmacy
• Landon James Nielsen, OTR/L
• Marian Janis Nielson, APRN-C

• Community/Retail Pharmacy in Nephi, UT
• Providers in Nephi, 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 Jun 18, 2018; 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.