Lifecare Specialty

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

8473547-1704 Issued in UT

Legal business name

LIFECARE SPECIALTY

Practice address

1646 Sunrise Place Ste B
West Jordan, UT 84084

Phone

(801) 676-0078

Fax

(801) 676-0079

NPI assigned

Mar 14, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Tyler L Nixon, RPH

Title

Owner

Phone

(801) 676-0078

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Lifecare Specialty Doing business as

Locations

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528329600000",
    "number": "1659612737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1646 SUNRISE PLACE STE B",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "84084",
            "telephone_number": "801-676-0078",
            "fax_number": "801-676-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1646 SUNRISE PLACE STE B",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "84084",
            "telephone_number": "801-676-0078",
            "fax_number": "801-676-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE SPECIALTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2018-06-07",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-676-0078",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "UT",
            "license": "8473547-1704",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "UT",
            "license": "84735471704",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4612481",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifecare Specialty",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifecare Specialty",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Long Term Care Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; 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.