Professional Park Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PROFESSIONAL PARK PHARMACY INC

Practice address

2825 East Mall Drive
St George, UT 84790-8479

Phone

(435) 429-6700

Fax

(435) 652-3059

NPI assigned

Nov 23, 2020

Organization subpart

Yes

Parent organization

PROFESSIONAL PARK PHARMACY TWOAs reported in NPPES

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

Authorized official

Name

Robert Brad Anderson, RPH

Title

President/Pharmacist

Phone

(435) 652-1548

Specialties & licenses 1

Addresses

Other names 1

• Professional Park Pharmacy Two Doing business as

Part of

Professional Park Pharmacy

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1780288571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 E MALL DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847901954",
            "telephone_number": "435-429-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 EAST MALL DRIVE",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908479",
            "telephone_number": "435-429-6700",
            "fax_number": "435-652-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PARK PHARMACY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL PARK PHARMACY TWO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRAD",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "435-652-1548",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Park Pharmacy Two",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Professional Park Pharmacy Two",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in St George, UT
• Providers in St George, 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 Mar 24, 2022; 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.