12TH STREET PHARMACY – NPI #1538284716
Pharmacy

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.

12TH STREET PHARMACY is a pharmacy located in OGDEN, UT. NPPES has assigned the NPI number 1538284716 to 12TH STREET PHARMACY on March 20, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “12TH STREET PHARMACY” is a dba name, the actual legal business name for this organization is 12TH ST PHARMACY INC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3336C0003X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Community/Retail Pharmacy

The NPI profile was previously updated about 10 years ago on Sep 23, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 12TH STREET PHARMACY below.

NPI Profile for
12TH ST PHARMACY INC

NPI Number
1538284716
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
12TH ST PHARMACY INC
Doing Business As (dba): 12TH STREET PHARMACY
Primary location
698 12TH ST
OGDEN, UT 84404-6200
Phone: (801) 621-2154 Fax: (801) 627-9523
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
WALLACE EGGLESTON
OWNER AND PHARMACIST
Phone: (801) 621-2154
Updated
Identifiers

Identifiers for 12TH STREET PHARMACY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERPK2100182
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336C0003X
- Pharmacy / Community/Retail Pharmacy (Primary)
UT 362500-1703
3336C0002X
- Pharmacy / Clinic Pharmacy
333600000X
- Pharmacy

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.