OrganizationActive
De Novo Services LLC
NPI 1164794434 · Institutional Pharmacy · Salt Lake City, UT
Provider details
- NPI number
- 1164794434
- Entity type
- Organization
- Primary specialty
- Institutional PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Jerry Costley, Director / Owner(801) 263-1056
Specialties & taxonomies
Suppliers
Behavioral Health & Social Service Providers
Allopathic & Osteopathic Physicians
Ambulatory Health Care Facilities
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
339 E 3900 S
Suite 155
Salt Lake City, UT 84107-1677
Phone: (801) 263-1056
Fax: (801) 261-3701
Street-level locationGet directions
Mailing address
339 E 3900 S
Salt Lake City, UT 84107-1677
Registry dates
- Enumerated
- 2012-02-02
- Last updated
- 2020-08-03
- Certified
- 2020-08-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.