Mountain West Medicine, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5731786-1703 Issued in UT

Legal business name

MOUNTAIN WEST MEDICINE, INC.

Practice address

1551 S Renaissance Towne Dr
Suite 104
Bountiful, UT 84010

Phone

(801) 295-6979

Fax

(801) 295-6989

NPI assigned

Dec 14, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Julie Suzanne Lindberg, PHARM D.NPI 1568694107

Title

Owner/Pharmacist

Phone

(801) 295-6979

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MountainWest Apothecary Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie Suzanne Lindberg, PHARM.D

  • Pharmacist
  • Edgewood, NM
  • NPI 1568694107
  NPD Authorized official

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1972665396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 S RENAISSANCE TOWNE DR",
            "address_2": "SUITE 104",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "84010",
            "telephone_number": "801-295-6979",
            "fax_number": "801-295-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 S RENAISSANCE TOWNE DR",
            "address_2": "SUITE 104",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "84010",
            "telephone_number": "801-295-6979",
            "fax_number": "801-295-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN WEST MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "LINDBERG",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "SUZANNE",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "801-295-6979",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "5731786-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201309057001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MountainWest Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mountain West Clinical Services
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• Mountain West Surgery Center, LLC
• Mountainstar Behavioral Health LLC
• Mountainstar Behavioral Health LLC
• Mountaintop Audiology LLC
• Mountainwest Surgical Center LLC

• Community/Retail Pharmacy in Bountiful, UT
• Providers in Bountiful, 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 Oct 15, 2020; 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.