Clearfield Job Corps Pharmacy

Primary specialty

Institutional PharmacyTaxonomy code 3336I0012X

License

1268151704 Issued in UT

Legal business name

CLEARFIELD JOB CORPS PHARMACY

Doing business as

Clearfield Job Corps Pharmacy

Practice address

20 W 1700 S
Clearfield, UT 84016-6004

Phone

(801) 416-4467

Fax

(801) 416-4636

NPI assigned

Jul 22, 2006

Last updated

Aug 7, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lori Henry, RM

Title

Wellness Administrator

Phone

(801) 416-4628

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CLEARFIELD JOB CORPS PHARMACY Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Clearfield Job Corps Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Inland Empire Job Corps Center

  • Student Health Clinic/Center
  • San Bernardino, CA
  • NPI 1922326180
  NPD tax ID
• Management & Training Corporation

  • Community/Behavioral Health Agency
  • Minot, ND
  • NPI 1881316578
  NPD tax ID

Locations

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.

• Darryl Hardy, APRN

  • Family Nurse Practitioner
  • Clearfield, UT
  • NPI 1306320155
  NPD (past)
• Brandy M Bates, PA-C

  • Medical Physician Assistant
  • Pocatello, ID
  • NPI 1487886560
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249603200000",
    "number": "1871514844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160070",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840160070",
            "telephone_number": "801-416-4467",
            "fax_number": "801-416-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W 1700 S",
            "city": "CLEARFIELD",
            "state": "UT",
            "postal_code": "840166004",
            "telephone_number": "801-416-4467",
            "fax_number": "801-416-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARFIELD JOB CORPS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2009-08-07",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "WELLNESS ADMINISTRATOR",
        "authorized_official_telephone_number": "801-416-4628",
        "authorized_official_credential": "RM"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "UT",
            "license": "1268151704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4601351",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLEARFIELD JOB CORPS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Christensen, DO
• Mindy Dyan Christiansen, PTA
• Marcie Clark
• Matt Clark
• Erin Davies Clawson, NP
• Clearfield MSL, LLC (Chancellor Gardens of Clearfield)
• Comfort Hospice Care
• Carie Lynn Comstock, CNM
• Aaron Cope, PHARMD
• Kevin Glenn Cox, DDS

• Institutional Pharmacy in Clearfield, UT
• Providers in Clearfield, UT by specialty
• Institutional Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.