| Mountainlands Family Pharmacy | |
|
589 S State St Provo UT 84606-5056 | |
| (801) 429-2000 | |
| Not Available |
| Full Name | Mountainlands Family Pharmacy |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 589 S State St, Provo, Utah |
| Authorized Official Name and Position | Todd Bailey (CEO) |
| Authorized Official Contact | 8014292011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountainlands Family Pharmacy 589 S State St Provo UT 84606-5056 Ph: (801) 429-2000 | Mountainlands Family Pharmacy 589 S State St Provo UT 84606-5056 Ph: (801) 429-2000 |
| NPI Number | 1871812370 |
|---|---|
| Provider Enumeration Date | 05/24/2010 |
| Last Update Date | 03/27/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871812370 | NPI | - | NPPES |
| 4611821 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
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