Uintah Basin Medical Center Inc
NPI 1417022864ActiveOrganization· Pharmacy· Roosevelt, UT
Pharmacy in Roosevelt, Utah, registered in NPPES in November 2006, part of Uintah Basin Medical Center Inc. The authorized official on file is James Marshall, Ceo. Enrolled in Medicare as part b supplier - mass immunization (roster biller only).
Overview
| NPI | 1417022864 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Uintah Basin Medical Center Inc |
| NPI issued | Nov 21, 2006 |
| Last updated in NPPES | Apr 16, 2021 |
| Certified by provider | Apr 16, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Pharmacy, Clinic Pharmacy | 3336C0002X | 4788706-1703 | UT |
| Pharmacy, Compounding Pharmacy | 3336C0004X | 4788706-1703 | UT |
| Pharmacy, Long Term Care Pharmacy | 3336L0003X | 4788706-1703 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Mass Immunization (Roster Biller Only) (UT) |
|---|
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