Organization · Type 2 NPI

Mountainlands Family Pharmacy - Wasatch

Federally Qualified Health Center (FQHC) · Provo, UT

NPI number 1861815110 Active

Practice location

750 N 200 W, Suite 201
Provo, UT 84601-3539

Mailing address

589 S State St
Provo, UT 84606-5056

Specialties and licenses

TaxonomyCodeLicense
Federally Qualified Health Center (FQHC) Primary 261QF0400XNone listed
Community/Retail Pharmacy 3336C0003XNone listed

Federally Qualified Health Center (FQHC): Definition to come...

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About NPI 1861815110

Mountainlands Family Pharmacy - Wasatch's National Provider Identifier is 1861815110, issued on Jan 22, 2014. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Provo, UT. The record was last updated on Mar 27, 2025.