NPIMap

Organization Active NPI

Canyonlands Community Health Care

  • Community/Retail Pharmacy
  • Page, AZ
National Provider Identifier
1689021933
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
Y006821 Issued in AZ
Legal business name
CANYONLANDS COMMUNITY HEALTH CARE
Doing business as
Canyonlands Community Healthcare
Practice address
467 Vista Avenue
Page, AZ 86040
Phone
(928) 645-6620
Fax
(928) 645-6621
NPI assigned
May 17, 2016
Last updated
Sep 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Andrew Lewandowski, PHARMDNPI 1518477819
Title
Director of Pharmacy, Pic, Ao
Phone
(928) 645-6620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Y006821 AZ Primary

Addresses

Primary practice location

467 Vista Avenue
Page, AZ 86040

Mailing address

PO Box 1625
Page, AZ 86040-1625
Phone (928) 645-6620

Other identifiers 3

IdentifierTypeStateIssuer
174027MedicaidAZ
1689021933MedicaidUT
2160535OtherPK

Other names 1

  • Canyonlands Community Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lake Powell Medical Cen15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1689021933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1625",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860401625",
            "telephone_number": "928-645-6620",
            "fax_number": "928-645-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 VISTA AVENUE",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "86040",
            "telephone_number": "928-645-6620",
            "fax_number": "928-645-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYONLANDS COMMUNITY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "LEWANDOWSKI",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY, PIC, AO",
        "authorized_official_telephone_number": "928-645-6620",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y006821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174027",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689021933",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160535",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyonlands Community Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Page, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.