Provider Type Icon

GREEN RIVER MEDICAL CENTER INC. NPI 1689134868


NPI Information

NPI: 1689134868
Provider Name: GREEN RIVER MEDICAL CENTER, INC.
Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 46D0717470

Address:
585 WEST MAIN STREET
GREEN RIVER, UT
ZIP 84525
Phone: (435) 564-3434
Get Directions

GREEN RIVER MEDICAL CENTER, INC. is a community/retail pharmacy pharmacy in Green River, UT. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. GREEN RIVER MEDICAL CENTER, INC. NPI is 1689134868. The provider is registered as an organization entity type.

The provider's business location address is:

585 WEST MAIN STREET
GREEN RIVER, UT
ZIP 84525
Phone: (435) 564-3434
Fax: (435) 564-3214

The provider's authorized official is Paula Jean Dunham .
The authorized official title is Executive Director and has the following contact phone number (435) 564-0213.

The CLIA number assigned to this NPI record is 46D0717470 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/22/2019 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
111065988-1703OTHERUTAHUTAH DOPL PHARMACY CLASS A LICENSE
211065988-8913OTHERUTAHUTAH DOPL DISPENSING CONTROLLED SUBSTANCE LICENSE
3261QF0400XMEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.