NPIMap

Organization Active NPI

Mountainlands Family Pharmacy - Wasatch

  • Federally Qualified Health Center (FQHC)
  • Provo, UT
National Provider Identifier
1861815110
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MOUNTAINLANDS FAMILY PHARMACY - WASATCH
Practice address
750 N 200 W
Suite 201
Provo, UT 84601-3539
Phone
(801) 429-2000
NPI assigned
Jan 22, 2014
Organization subpart
Yes
Parent organization
MOUNTAINLANDS COMMINITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Mr. Todd Bailey
Title
Ceo
Phone
(801) 429-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Community/Retail Pharmacy 3336C0003X UT

Addresses

Primary practice location

750 N 200 W
Suite 201
Provo, UT 84601-3539

Mailing address

589 S State St
Provo, UT 84606-5056
Phone (801) 429-2020

National Provider Directory

National Provider Directory
Tax ID family
Mountainlands Family Pharmacy12 organizations share this tax ID, including this one
Part of
Mountainlands Family Pharmacy

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1861815110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-429-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N 200 W",
            "address_2": "SUITE 201",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846013539",
            "telephone_number": "801-429-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINLANDS FAMILY PHARMACY - WASATCH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNTAINLANDS COMMINITY HEALTH CENTER",
        "enumeration_date": "2014-01-22",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-429-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.