Organization Active NPI

University of Utah

Doing business as Huntsman Cancer Retail Pharmacy

  • Community/Retail Pharmacy
  • Salt Lake City, UT
National Provider Identifier
1861582843
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8079984-1703 Issued in UT
Legal business name
UNIVERSITY OF UTAH
Doing business as
Huntsman Cancer Retail Pharmacy
Huntsman Outpatient Pharmacy
Practice address
1950 Circle of Hope Dr
Ste 2110
Salt Lake City, UT 84112-5500
Phone
(801) 585-0172
Fax
(801) 585-2988
NPI assigned
Oct 13, 2006
Last updated
May 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Kellee K Howell, CPHT
Title
Pharmacy Business Operations Manage
Phone
(801) 587-6334

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 8079984-1703 UT Primary
Institutional Pharmacy 3336I0012X NU

Addresses

Primary practice location

1950 Circle of Hope Dr
Ste 2110
Salt Lake City, UT 84112-5500

Mailing address

PO Box 841208
Los Angeles, CA 90084-1208
Phone (801) 587-6334

Other identifiers 2

IdentifierTypeStateIssuer
2100689OtherPK
4609282OtherNCPDP

Other names 2

  • HUNTSMAN CANCER RETAIL PHARMACY Doing business as
  • Huntsman Outpatient Pharmacy Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930084871 UT DME Supplier - Pharmacy 0749262665 Practice locations: Salt Lake City, UT
O20201021001587 UT Part B Supplier - Mass Immunization (Roster Biller Only) 0749262665 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salt Lake City, UT; Taylorsville, UT; Stansbury Park, UT; South Jordan, UT; Park City, UT; Orem, UT; Midvale, UT; Farmington, UT…

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Division of Artificial54 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

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

View all 19

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
University of Utah Hospitals and ClinicsSalt Lake City, UT, CCN 460009 Hospital 5% Or Greater Direct Ownership Interest Jun 17, 1966
University of UtahSalt Lake City, UT, CCN 46T009 Hospital 5% Or Greater Direct Ownership Interest Jun 17, 1966

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1861582843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841208",
            "telephone_number": "801-587-6334",
            "fax_number": "801-587-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE DR",
            "address_2": "STE 2110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125500",
            "telephone_number": "801-585-0172",
            "fax_number": "801-585-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "HOWELL",
        "authorized_official_first_name": "KELLEE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHARMACY BUSINESS OPERATIONS MANAGE",
        "authorized_official_telephone_number": "801-587-6334",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "8079984-1703",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2100689",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4609282",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HUNTSMAN CANCER RETAIL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HUNTSMAN CANCER RETAIL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Huntsman Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.