PC PHARMACY AT THE CLINIC INC (NPI# 1124132113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124132113 |
| Entity Type | Organization |
| Organization Name | PC PHARMACY AT THE CLINIC INC |
| Other Organization Name | PARK CITY PHCY AT THE CLINIC |
| Practice Address |
1665 Bonanza Dr Park City UT 84060 |
| Mailing Address |
Po Box 680772 Park City UT 84068-0772 |
| Practice Telephone | 4356585051 |
| Practice Fax Number | 4356585093 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KRISTY BLACK (OWNER) |
| Authorized Official Telephone | 4356585051 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 333600000X | Pharmacy | 60427351703 | UT | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4609547 | 01 |
| Other Name | Type Code |
|---|---|
| PARK CITY PHCY AT THE CLINIC | Doing Business As Name - Organization |
| Street Address |
1665 BONANZA DR |
| City | PARK CITY |
| State | UT |
| Zip Code | 84060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265439236 | Stefani Jane Day | Family Medicine | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2005-07-05 |
| 1437692324 | Ihc Health Services Inc | Preventive Medicine | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2016-11-23 |
| 1417223892 | Tin Vuong | Family Medicine | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2012-03-29 |
| 1457622706 | Cody Allen Walker | Pharmacist | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2012-01-18 |
| 1447534169 | Amy Beth Arriola | Physician Assistant | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2011-09-29 |
| 1730462110 | Pharmacy At Park City Clinic | Pharmacy | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2011-09-22 |
| 1639406705 | Mary Catherine Schindeler | Physician Assistant | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2009-11-11 |
| 1053564179 | Shari Bloom | Physician Assistant | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2008-11-03 |
| 1528183597 | Ihc Health Services | Clinic/Center | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2007-03-20 |
| 1861423113 | Cress Roy Bohnn | Legal Medicine | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2006-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982233920 | Livecare, Inc. | Nursing Care | 1830 Prospector Avenue, Park City, UT 84060 | 2020-04-02 |
| 1063904266 | Louise Knetzger Gallagher | Acupuncturist | 1107 Woodside Ave, Park City, UT 84060 | 2018-06-04 |
| 1942753421 | Valerie Alison Mey | Dietitian, Registered | 2985 Arabian Dr, Park City, UT 84060 | 2016-08-01 |
| 1659720936 | Vibrant Health PC | Anesthesiology | 1910 Prospector Ave Suite 302, Park City, UT 84060 | 2016-06-08 |
| 1538538657 | Pamela Hilbert | Dentist | 1830 Prospector Ave., Park City, UT 84060 | 2015-09-18 |
| 1174904924 | Julie Anna Bullen | Counselor | 2300 Monitor Drive, Park City, UT 84060 | 2015-06-17 |
| 1265825319 | William Gary Smith | Obstetrics & Gynecology | 2501 Creek Drive, Park City, UT 84060 | 2015-03-13 |
| 1497026330 | Earl Warren Stadler Jr. | Physical Medicine & Rehabilitation | 1500 Three Kings Drive Unit 31, Park City, UT 84060 | 2012-01-24 |
| 1538454541 | Belinda Duncan | Pharmacist | 2700 E Deer Valley Dr B105, Park City, UT 84060 | 2011-06-17 |
| 1184888315 | Cody Michael Calderwood | Dentist | 1600 Snow Creek Dr Ste A, Park City, UT 84060 | 2008-07-16 |
| Find all providers in zip 84060 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245521954 | Park City Clinic Pharmacy | Pharmacy | 750 Round Valley Dr, 203, Park City, UT 84098 | 2011-04-28 |
| 1013006600 | University of Utah | Pharmacy | 1743 Redstone Center Dr, Ste 115, Park City, UT 84098-7929 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093502 | Alan Keith Bennion | Pharmacy | 5761 S Surreyrun Rd, Murray, UT 84107-6610 | 2020-11-07 |
| 1558919142 | University of Utah | Pharmacy | 1280 E. Stringham Ave, Suite 101, Salt Lake City, UT 84106 | 2019-08-28 |
| 1528525508 | Skull Valley Health Clinic | Pharmacy | 1929 N Aaron Dr Ste I, Tooele, UT 84074-8112 | 2019-02-26 |
| 1639649916 | Midland Pharmacy, LLC | Pharmacy | 4815 S 3500 W, Roy, UT 84067-9439 | 2018-11-29 |
| 1235628223 | Meds In Motion, LLC | Pharmacy | 12101 S State St, Suite 101a, Draper, UT 84120 | 2018-05-04 |
| 1114439775 | Fusion Pharmacy LLC | Pharmacy | 617 E Riverside Dr Ste 104, St George, UT 84790 | 2017-11-03 |
| 1568973055 | Eco Apothecary LLC | Pharmacy | 3701 S State Street Suite 114, South Salt Lake City, UT 84115 | 2017-10-24 |
| 1770021388 | Crimson Valley Pharmacy LLC | Pharmacy | 2351 S River Rd, Ste 3, Saint George, UT 84790-8280 | 2017-02-02 |
| 1013454396 | Gfy LLC | Pharmacy | 189 S State St Ste 120, Clearfield, UT 84015-1062 | 2017-01-25 |
| 1083157382 | Badger Management LLC | Pharmacy | 725 N Redwood Road, N Salt Lake, UT 84054 | 2016-11-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.