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NPI 1174552848 · Community/Retail Pharmacy · Provo, UT
Provider details
- NPI number
- 1174552848
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Gary Allen, President(801) 489-4377
- License
- 221250201703 (UT)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
655 E 300 S
Provo, UT 84606-4962
Phone: (801) 375-5005
Fax: (801) 375-1506
Street-level locationGet directions
Mailing address
655 E 300 S
Provo, UT 84606-4962
Registry dates
- Enumerated
- 2006-07-03
- Last updated
- 2015-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.