NPIMap

Organization Active NPI

Smiths Food & Drug Centers Inc

  • Community/Retail Pharmacy
  • Logan, UT
National Provider Identifier
1780601302
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1319971703 Issued in UT
Legal business name
SMITHS FOOD & DRUG CENTERS INC
Practice address
442 N 175 E
Logan, UT 84321-5570
Phone
(435) 753-6570
Fax
(435) 750-0931
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Authorized official

Name
Victoria Lynn Andrews
Title
Manager of Licensing
Phone
(513) 762-1090

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1319971703 UT Primary

Addresses

Primary practice location

442 N 175 E
Logan, UT 84321-5570

Mailing address

PO Box 842772
Boston, MA 02284-2772
Phone (513) 762-1019

Other identifiers 2

IdentifierTypeStateIssuer
2099734OtherPK
807335500MedicaidID

Other names 1

  • SMITHS PHARMACY #87 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050505000127 UT Part B Supplier - Mass Immunization (Roster Biller Only) 4284674698 This NPI is an additional NPI on the enrollment
O20100930070787 UT DME Supplier - PharmacyDME Supplier - Grocery Store 4284674698 Practice locations: Logan, UT

National Provider Directory

National Provider Directory
Tax ID family
Smiths Drug King274 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

442 N 175 E
Logan, UT 84321
Phone (435) 753-6570

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1780601302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022842772",
            "telephone_number": "513-762-1019",
            "fax_number": "513-762-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 N 175 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843215570",
            "telephone_number": "435-753-6570",
            "fax_number": "435-750-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHS FOOD & DRUG CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER OF LICENSING",
        "authorized_official_telephone_number": "513-762-1090"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "1319971703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2099734",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807335500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMITHS PHARMACY #87",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SMITHS PHARMACY #87",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.