MAGELLAN RX PHARMACY, LLC (NPI# 1609221647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609221647 |
| Entity Type | Organization |
| Organization Name | MAGELLAN RX PHARMACY, LLC |
| Practice Address |
2256 S 3600 W Ste A Salt Lake City UT 84119-1124 |
| Practice Telephone | 8552714810 |
| Practice Fax Number | 8014336219 |
| Mailing Telephone | 8552714810 |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2017-04-05 |
| Authorized Official Name | KUO HUNG WONG (VP PHARMACY OPERATIONS) |
| Authorized Official Telephone | 14078586206 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
9771246-1703 | UT | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548390131 | Magellan Rx Pharmacy, LLC | Pharmacy | 31-75 23rd St, Suite 410, Astoria, NY 11106-4134 | 2007-03-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MAGELLAN RX PHARMACY, LLC | 8621 Robert Fulton Drive, Columbia, Md 21046 |
| Connecticut Business Registrations | MAGELLAN RX PHARMACY, LLC | 6950 Columbia Gateway Drive, Columbia, MD 21046 |
| Indiana Business Entities | MAGELLAN RX PHARMACY, LLC | 6950 Columbia Gateway Dr, Columbia, MD 21046 |
| Washington State Corporations | MAGELLAN RX PHARMACY, LLC | 8621 Robert Fulton Drive, Columbia, MD 21046-2706 |
| Street Address |
2256 S 3600 W STE A |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84119-1124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356790364 | Magellan Rx Pharmacy LLC | Pharmacy | 2256 S 3600 W Ste A, Salt Lake City, UT 84119-1124 | 2016-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164981932 | Arches Home Care, Inc. | Non-emergency Medical Transport (VAN) | 1385 W 2200 S Ste 203, West Valley City, UT 84119 | 2019-03-19 |
| 1629591003 | Exemplar Healthcare, Inc. | Hospice Care, Community Based | 1385 W 2200 S Ste 202, West Valley City, UT 84119 | 2017-07-18 |
| 1619358496 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 2875 S Decker Lake Dr Ste 180, West Valley City, UT 84119 | 2015-06-17 |
| 1821407735 | Nathan William Stobbe | Dentist | 3280 W. 3500 S. Ste 3, West Valley, UT 84119 | 2014-08-05 |
| 1801209028 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3148 W 3500 S, West Valley City, UT 84119 | 2014-06-05 |
| 1215347935 | Karl Edward Jennings | Social Worker | 3901 S David Pl, West Valley City, UT 84119 | 2014-05-02 |
| 1750624672 | Shannon Quinn Dunlop | Registered Nurse | 2621 S 3270 W, West Valley City, UT 84119 | 2013-03-28 |
| 1215273529 | Holly H Tanski | Counselor | 5770 S. 1500 W. Bld A, Ihc Wasatch Canyons Campus, Salt Lake City, UT 84119 | 2012-12-14 |
| 1982955860 | Oquirrh Meadows Care and Rehab, Inc | Assisted Living Facility | 2948 So. Redwood Road, West Valley City, UT 84119 | 2012-10-02 |
| 1518235068 | Asjad Kaleem Mohammed | Pharmacist | 2290 S Redwood Road, Olive Pharmacy, Salt Lake City, UT 84119 | 2011-12-12 |
| Find all providers in zip 84119 | ||||
| Taxonomy Code | 3336M0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Mail Order Pharmacy |
| A pharmacy where pharmacists compound or dispense prescriptions or other medications in accordance with federal and state law, using common carriers to deliver the medications to patient or their caregivers. Mail order pharmacies counsel patients and caregivers (sometimes independent of the dispensing process) through telephone or email contact and provide other professional services associated with pharmaceutical care appropriate to the setting. Mail order pharmacies are licensed as a Mail Order Pharmacy in the state where they are located and may also be licensed or registered as nonresident pharmacies in other states. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124267117 | Skin Care Rx L L C | Pharmacy | 1055 S 700 W, Salt Lake City, UT 84104-1504 | 2009-02-13 |
| 1235153826 | Longs Drug Store California Inc | Pharmacy | 221 Charles Lindbergh Dr, Salt Lake City, UT 84116-2811 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205061538 | Pcm Venture I Pharmacy | Pharmacy | 9836 S Jordan Gtwy, Sandy, UT 84070-9509 | 2009-05-15 |
| 1194761585 | Roots Pharmaceuticals Inc | Pharmacy | 12 W 100 N, Ste 201b, American Fork, UT 84003-1611 | 2006-06-22 |
| 1841647179 | Blue Eyes of Utah LLC | Pharmacy | 157 E Riverside Dr, Suite 3e, St George, UT 84790-6886 | 2016-05-17 |
| 1821286691 | University of Utah South Jordan Mail Order Pharmacy | Pharmacy | 1091 W South Jordan Pkwy, South Jordan, UT 84095-8820 | 2007-10-05 |
| 1033264130 | Sundance Pharmacy LLC | Pharmacy | 538 N 1300 E, Saint George, UT 84770-3222 | 2007-01-25 |
| City | SALT LAKE CITY |
| Zip Code | 84119 |
Please comment or provide details below to improve the information on MAGELLAN RX PHARMACY, LLC.
| 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.