| Mountainlands Family Pharmacy - Wasatch | |
|
750 N 200 W Suite 201 Provo UT 84601-3539 | |
| (801) 429-2000 | |
| Not Available |
| Full Name | Mountainlands Family Pharmacy - Wasatch |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 750 N 200 W, Provo, Utah |
| Authorized Official Name and Position | Todd Bailey (CEO) |
| Authorized Official Contact | 8014292000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountainlands Family Pharmacy - Wasatch 589 S State St Provo UT 84606-5056 Ph: (801) 429-2020 | Mountainlands Family Pharmacy - Wasatch 750 N 200 W Suite 201 Provo UT 84601-3539 Ph: (801) 429-2000 |
| NPI Number | 1861815110 |
|---|---|
| Provider Enumeration Date | 01/22/2014 |
| Last Update Date | 03/27/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861815110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 3336C0003X | Pharmacy - Community/retail Pharmacy | (Utah) | Secondary |
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