OrganizationActive
Mountainlands Family Pharmacy - Wasatch
NPI 1861815110 · Federally Qualified Health Center (FQHC) · Provo, UT
Provider details
- NPI number
- 1861815110
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Mountainlands Comminity Health Center
- Organization subpart
- Yes
- Authorized official
- Todd Bailey, Ceo(801) 429-2000
Specialties & taxonomies
Ambulatory Health Care Facilities
- Community/Retail Pharmacy3336C0003X
Suppliers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 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
750 N 200 W
Suite 201
Provo, UT 84601-3539
Phone: (801) 429-2000
Street-level locationGet directions
Mailing address
589 S State St
Provo, UT 84606-5056
Registry dates
- Enumerated
- 2014-01-22
- Last updated
- 2025-03-27
- Certified
- 2025-03-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.