Family Plaza Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

6732558-1703 Issued in UT

Legal business name

FAMILY PLAZA PHARMACY INC

Practice address

3570 W 9000 S
Ste 150
West Jordan, UT 84088-8869

Phone

(801) 569-0175

Fax

(801) 569-8941

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Shane Jensen, PHARMD

Title

Owner

Phone

(801) 569-0175

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• FAMILY PLAZA PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 3

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

• Phil Olsen, PHARMD

  • Pharmacist
  • West Jordan, UT
  • NPI 1689265290
  NPD
• Justin Harpole, CPHT

  • Pharmacy Technician
  • West Jordan, UT
  • NPI 1851257620
  NPD (past)
• Micah Heathcote

  • Pharmacist
  • Kearns, UT
  • NPI 1205706942
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1831171941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 W 9000 S",
            "address_2": "STE 150",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888869",
            "telephone_number": "801-569-0175",
            "fax_number": "801-569-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 W 9000 S",
            "address_2": "STE 150",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888869",
            "telephone_number": "801-569-0175",
            "fax_number": "801-569-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PLAZA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-569-0175",
        "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": "UT",
            "license": "6732558-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2099816",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY PLAZA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Families First Orthodontics
• Families First Pediatric Dentistry
• Families First Pediatrics LLC
• Family Development Center
• Family Plaza Pharmacy Inc
• Family Surgical Suite
• Ryan Farmer, PHARM D
• Heston Farnsworth, D.M.D.
• McKala Farnsworth, LMT
• Kylie Farnworth

• Community/Retail Pharmacy in West Jordan, UT
• Providers in West Jordan, 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 Aug 12, 2016; 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.