Maple Mountain Pharmacy

LBN: Maple Mountain Pharmacy Inc
Maple Mountain Pharmacy is an health care organization with primary practice located at 724 S 1600 W , Mapleton UT 84664-4342. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Maple Mountain Pharmacy Inc can be contacted via phone (801) 515-6048, or through Johnson, Michael via phone (801) 885-1147.

Contact Information

Primary practice address
724 S 1600 W Mapleton UT 84664-4342
Phone: (801) 515-6048
Fax: (855) 848-5748
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Michael
Phone: (801) 885-1147

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 8359109-1703 Utah
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1457603037
LBN Legal business name Maple Mountain Pharmacy Inc
DBA Doing business as Maple Mountain Pharmacy
Authorized official Johnson, Michael
Entity Organization
Organization subpart 1 No
Enumeration date Oct 8th, 2012
Last updated Apr 22nd, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457603037 NPPES
Utah MEDICAID 1457603037
Utah Other 2137217

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