Holladay Pharmaceutical LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

7686605-1703 Issued in UT

Legal business name

HOLLADAY PHARMACEUTICAL LLC

Doing business as

Orem Family Pharmacy

Practice address

406 N State St
Orem, UT 84057-3802

Phone

(801) 434-7670

Fax

(801) 434-7669

NPI assigned

Jun 11, 2010

Organization subpart

No

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

Authorized official

Name

Penny Jo Gustafson

Title

Manager

Phone

(801) 756-4021

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Orem Family 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, and the practitioner matching its NPPES authorized official.

• David Wilson, PHARMD

  • Pharmacist
  • Vineyard, UT
  • NPI 1598386856
  NPD
• Casey Allen, PHARMD, BCPS

  • Pharmacotherapy Pharmacist
  • Orem, UT
  • NPI 1215587464
  NPD (past)
• Michelle Lee Chandler, CPHT

  • Pharmacy Technician
  • Provo, UT
  • NPI 1427678242
  NPD (past)

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778803200000",
    "number": "1881915957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 N 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032952",
            "telephone_number": "801-434-7670",
            "fax_number": "801-434-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840573802",
            "telephone_number": "801-434-7670",
            "fax_number": "801-434-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLADAY PHARMACEUTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-11",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-756-4021"
    },
    "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": "7686605-1703",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125523",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881915957",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orem Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orem Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Gunther Hodge, MS,CCC-SLP
• Kathleen Slade Hofer, M.A.P.C., C.P.C.E.
• Campbell Hofstetter
• Emma Sherin Hoggard
• McCall Holbrook
• Susan Holley
• Lynn Nolan Hollingshead
• Maya Hollingshead
• McKenna Hollingsworth
• Katherine Holmes

• Community/Retail Pharmacy in Orem, UT
• Providers in Orem, 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 May 15, 2026; 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.