Granger Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

10310634-1703 Issued in UT

Legal business name

GRANGER PHARMACY

Doing business as

Granger Pharmacy,LLC

Practice address

2965 W 3500 S
West Valley City, UT 84119-3602

Phone

(801) 965-3639

Fax

(801) 965-9641

NPI assigned

Jan 26, 2007

Last updated

Feb 13, 2025By 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

Mr. Bryan Allred, PHARM. D.NPI 1073852018

Title

Owner

Phone

(801) 597-5650

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Granger Pharmacy,LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Tax ID family

Granger Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Granger Pharmacy

  • Pharmacist
  • West Valley, UT
  • NPI 1548791270
  NPD tax ID

Locations

Practitioners 1

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.

• Bryan Allred

  • Pharmacist
  • West Valley, UT
  • NPI 1073852018
  NPD Authorized official

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1922154756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S # W3500S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3639",
            "fax_number": "801-965-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3639",
            "fax_number": "801-965-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANGER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "ALLRED",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-597-5650",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "UT",
            "license": "10310634-1703",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "10310634-1703",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922154756",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139745",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granger Pharmacy,LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Granger Pharmacy,LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Granger Medical Clinic, PC
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• Granger Pediatric Dentistry
• Granger Pharmacy
• Adam Adair Green, MFTI
• Annalisa Gregory, CSW
• Taylor Gregrich, CSW
• Katherine G Griffin, A.P.R.N.
• Shannon Brooke Grizzle, CSW

• Pharmacy in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.