Provider Demographics
NPI:1306115274
Name:HARMON CITY INC
Entity type:Organization
Organization Name:HARMON CITY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-957-8454
Mailing Address - Street 1:3540 S 4000 W
Mailing Address - Street 2:STE #430
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-3260
Mailing Address - Country:US
Mailing Address - Phone:801-902-8512
Mailing Address - Fax:801-964-6923
Practice Address - Street 1:135 E 100 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-6500
Practice Address - Country:US
Practice Address - Phone:801-428-0399
Practice Address - Fax:801-428-0390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336S0011X
UT8152983-17033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1306115274Medicaid
2133078OtherPK
2133078OtherPK