Edgemont Pharmacy

LBN: Red Beaker Inc
Edgemont Pharmacy is an health care organization with primary practice located at 3661 N Canyon Rd , Provo UT 84604-4536. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Red Beaker Inc can be contacted via phone (801) 226-7994, or through Chamberlain, Mike via phone (801) 226-7994.

Contact Information

Primary practice address
3661 N Canyon Rd Provo UT 84604-4536
Phone: (801) 226-7994
Fax: (801) 226-2166
Website:
Map and Directions
Authorized official contact:
Name: Chamberlain, Mike RPH
Phone: (801) 226-7994

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 45500841703 Utah

Profile Details

NPI number 1659301885
LBN Legal business name Red Beaker Inc
DBA Doing business as Edgemont Pharmacy
Authorized official Chamberlain, Mike RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jul 4th, 2006
Last updated Jul 19th, 2018 - about 8 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 1659301885 NPPES
Other 2107781 PK
MEDICAID 870349306009 PK

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