NPI 1033199666 · live from the CMS NPI Registry
Diabetes Specialty Center
Pharmacy in Salt Lake City, UT. National Provider Identifier 1033199666, active.
NPI record
| NPI | 1033199666 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy 333600000X |
| Practice location | 3744 Second Street, Ste A, Salt Lake City, UT 84115 |
| Practice phone | 801-268-9699 |
| Mailing address | 3793 South State Street, Salt Lake City, UT 84115 |
| Enumerated | January 19, 2006 |
| Last updated | March 7, 2023 |
| Authorized official | Kim Doman, Controller |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy | 333600000X | 5738699-1703 (UT) |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | 5738699-1703 (UT) |
| Pharmacy primary | 333600000X | 8021342-1703 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.