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Export Provider Record NPI 1104915792
University Of Utah
Organization Subpart: NO
Active
NPI Number1104915792
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1104915792
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-10-12
Last Updated2021-03-16
Authorized OfficialKellee Howell
Pharmacy Business Operation Manager
Phone: 8015876334
Mailing AddressPo Box 841208
Los Angeles, CA 90084-1208
United States
Phone: (801) 587-6334 | Fax: (801) 587-2996
📍 View Map
Primary Practice Address26 S Main St, Ste 100
Centerville, UT 84014-1817
United States
Phone: (801) 693-7950 | Fax: (801) 693-7955
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)2100899PK
Other (non-Medicare)4610588NCPDP
MEDICAIDUT=========
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes3336C0003X – Pharmacy, Community/Retail PharmacyUT62502141703
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About NPI 1104915792

University Of Utah is an organization registered in the CMS NPPES NPI Registry with NPI number 1104915792. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Centerville, UT. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-10-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1104915792?

NPI 1104915792 belongs to University Of Utah, a Pharmacy, Community/Retail Pharmacy in Centerville, UT. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1104915792 active?

The current status of NPI 1104915792 in the NPPES registry is Active. The record was last updated on 2021-03-16.

What specialty is NPI 1104915792?

NPI 1104915792 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1104915792?

You can verify NPI 1104915792 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1104915792?

The primary practice address on file for NPI 1104915792 is 26 S Main St, Centerville, UT 84014-1817. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1104915792 issued?

NPI 1104915792 was first issued (enumerated) on 2006-10-12. The NPPES record was last updated on 2021-03-16.

Practice Location Map

University Of Utah is located at 26 S Main St, Centerville, UT. Use the map below to find directions or verify the practice location.

📍 26 S Main St, Centerville, UT 84014-1817  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as University Of Utah. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1104915792. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail Pharmacy62502141703UT
Data Verified from CMS NPPES Last synced: 2026-06-26 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162