Roe RX Inc
Organization Active NPI Community/Retail Pharmacy · Clinton, UT
NPI 1912376849 · NPPES record last updated Mar 15, 2022
Key facts
- NPI
- 1912376849
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 95330441703 (UT)
- Legal business name
- ROE RX INC
- Practice address
- 1407 N 2000 W Ste E
Clinton, UT 84015-8563 - Phone
- (801) 784-5495
- Fax
- (801) 784-5499
- NPI assigned
- Sep 22, 2015
- Organization subpart
- No
Authorized official
- Name
- Hal Roe, RPH
- Title
- Owner,Pic,Ao
- Phone
- (801) 698-2497
Other NPIs on the same Medicare enrollment 7
Corporate family (same tax ID) 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201013002983 | UT | Part B Supplier - Pharmacy | 2365569894 |
7 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Clinton, UT; Eden, UT; Farr West, UT; Ogden, UT; Pleasant View, UT; West Point, UT |
National Provider Directory
- Tax ID family
- Ok Pharmacy Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 95330441703 | UT | Yes |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
1407 N 2000 W Ste E
Clinton, UT 84015-8563
Mailing address
1378 W 1800 N
Ogden, UT 84404-2826
Phone (801) 782-3611
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2153048 | Other | PK | |
| 1912376849 | Medicaid | UT |
Other names
- Westside Health Mart
Other providers in Clinton, UT
- Q Mental Health LLC
- Collette Campbell Renstrom
- Resurgencepro
- Ridgeline Clinton LLC
- Kilee Danielle Robinson
- John Lee Roring
- Allen Rose
- Dennis C Roseth
- Hailey Russell
- Emily Ann Salisbury
All providers in Clinton, UT · Community/Retail Pharmacy in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.