NPI 1952158982 · live from the CMS NPI Registry
Confederated Tribes Of The Goshute Reservation
Pharmacy, Clinic Pharmacy in West Valley City, UT. National Provider Identifier 1952158982, active.
NPI record
| NPI | 1952158982 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Clinic Pharmacy 3336C0002X |
| Practice location | 3535 S Market St Ste 200, West Valley City, UT 84119 |
| Practice phone | 801-359-2256 |
| Mailing address | 660 S 200 E Ste 250, Salt Lake City, UT 84111 |
| Enumerated | May 6, 2024 |
| Last updated | December 19, 2024 |
| Authorized official | Carissa Monroy, Medical Officer |
| Other names | Sacred Circle Healthcare |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 332800000X | — |
| Pharmacy, Clinic Pharmacy primary | 3336C0002X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.