BLUE EYES OF UTAH LLC (NPI# 1841647179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841647179 |
| Entity Type | Organization |
| Organization Name | BLUE EYES OF UTAH LLC |
| Other Organization Name | MOUNTAIN RANGE PHARMACY |
| Practice Address |
157 E Riverside Dr Suite 3e St George UT 84790-6886 |
| Mailing Address |
205 E Main St Omro WI 54963-1417 |
| Practice Telephone | 4353591805 |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2016-08-06 |
| Authorized Official Name | MR. KENNETH ALLEN BRESSERS (SOLE MEMBER) |
| Authorized Official Telephone | 9206855041 |
| Authorized Official Credential | R.PH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
9777440-1704 | UT | Suppliers |
| Other Name | Type Code |
|---|---|
| Mountain Range Pharmacy | Doing Business As Name - Organization |
| Street Address |
157 E RIVERSIDE DR SUITE 3E |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-6886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568787190 | Chris Bain | Hearing Instrument Specialist | 157 E Riverside Dr, Suite 3d, St George, UT 84790-6886 | 2010-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| 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 |
|---|---|---|---|---|
| 1609221647 | Magellan Rx Pharmacy, LLC | Pharmacy | 2256 S 3600 W Ste A, Salt Lake City, UT 84119-1124 | 2016-04-27 |
| 1205061538 | Pcm Venture I Pharmacy | Pharmacy | 9836 S Jordan Gtwy, Sandy, UT 84070-9509 | 2009-05-15 |
| 1124267117 | Skin Care Rx L L C | Pharmacy | 1055 S 700 W, Salt Lake City, UT 84104-1504 | 2009-02-13 |
| 1194761585 | Roots Pharmaceuticals Inc | Pharmacy | 12 W 100 N, Ste 201b, American Fork, UT 84003-1611 | 2006-06-22 |
| 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 |
| 1235153826 | Longs Drug Store California Inc | Pharmacy | 221 Charles Lindbergh Dr, Salt Lake City, UT 84116-2811 | 2006-07-27 |
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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.