Wasatch Front LTC Pharmacy

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

9012387-1704 Issued in UT

Legal business name

WASATCH FRONT LTC PHARMACY

Practice address

11585 S State St Ste 103
Draper, UT 84020-7403

Phone

(801) 890-0346

Fax

(801) 542-0491

NPI assigned

Jul 31, 2014

Organization subpart

No

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

Authorized official

Name

Brandon Hagen

Title

Director of Operations

Phone

(801) 890-0346

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pioneer Pharmacy Services Doing business as

Locations

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1760890016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11585 S STATE ST",
            "address_2": "STE 103",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207400",
            "telephone_number": "801-890-0346",
            "fax_number": "801-542-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11585 S STATE ST STE 103",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207403",
            "telephone_number": "801-890-0346",
            "fax_number": "801-542-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH FRONT LTC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "801-890-0346"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "UT",
            "license": "9012387-1704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147019",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pioneer Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda S Ware
• Steven H. Warnock, M.D.
• Robert D Warren, ANP
• Justin Scott Wartena
• Harmony Warthen
• Wasatch Peaks Anesthesia LLC
• Wasathc Health Solutions
• Samuel Washington
• Tori Washington
• Kecia Kristine Watson, FNP-C

• Long Term Care Pharmacy in Draper, UT
• Providers in Draper, 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 Jul 31, 2014; 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.