UTAH STATE HOSPITAL PHARMACY
NPI 1316218449
Pharmacy - Institutional Pharmacy in Provo, UT
NPI Status: Active since January 20, 2012
Contact Information
1300 EAST CENTER STREET
PROVO, UT
ZIP 84606
Phone: (801) 344-4601
Fax: (801) 344-4604
- Organization
- Pharmacy
- Institutional Pharmacy
- Accepts Insurance
- CLIA Number: 46D0525415
- CLIA Cert. Type: Other
- CLIA Exp. Date: 01-02-2027
About UTAH STATE HOSPITAL PHARMACY
This page provides the complete NPI Profile along with additional information for Utah State Hospital Pharmacy, a provider established in Provo, Utah operating as a Pharmacy, focusing in institutional pharmacy . The healthcare provider is registered in the NPI registry with number 1316218449 assigned on January 2012. The practitioner's primary taxonomy code is 3336I0012X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Mr. Dallas L. Earnshaw (Superintendent)
- NPI
- 1316218449
- Provider Name
- UTAH STATE HOSPITAL PHARMACY
- Entity Type
- Organization
- Location Address
- 1300 EAST CENTER STREET PROVO, UT 84606
- Location Phone
- (801) 344-4601
- Location Fax
- (801) 344-4604
- Mailing Address
- PO BOX 270 PROVO, UT 84603
- Mailing Phone
- (801) 344-4601
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-20-2012
- Last Update Date
- 07-25-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Institutional Pharmacy
- Taxonomy Code
- 3336I0012X
- Type
- Suppliers
- Taxonomy Description
- A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 1 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care - EPO
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - EPO
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
- Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision - EPO
- Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
- Avera $1800 - PPO
- Avera $2000 - PPO
- Avera $4000 - PPO
- Avera $4500 - PPO
- Avera $6000 - PPO
- Avera $7500 HSA Eligible HDHP - PPO
- Avera $9200 - PPO
- Avera Standard $1500 - PPO
- Avera Standard $5000 - PPO
- Avera Standard $7500 - PPO
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Elite Gold HMO 004 (Two free PCP visits, $0 Pediatric PCP visits) - HMO
- BSW Elite Gold HMO 012 - HMO
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Prime Silver HMO 008 (Two free PCP visits, $0 Pediatric PCP visit) - HMO
- BSW Prime Silver HMO 005 - HMO
- BSW Savers Bronze HMO H S A 006 - HMO
- BSW Vital Bronze HMO 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Vital Bronze HMO 009 (One free PCP visit, $0 Pediatric PCP visit) - HMO
- BlueCross B07E HSA - EPO
- BlueCross B07S HSA - EPO
- BlueCross B15E $0 virtual care from Teladoc Health � - EPO
- BlueCross B15S $0 virtual care from Teladoc Health � - EPO
- BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental - EPO
- BlueCross B17S $0 virtual care from Teladoc Health � + Adult Dental - EPO
- BlueCross G06E $35 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental - EPO
- BlueCross S29S $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental - EPO
- Balance by Medica Bronze $0 Copay PCP Visits - EPO
- Balance by Medica Bronze $0 Copay PCP Visits - PPO
- Balance by Medica Bronze Premier - EPO
- Balance by Medica Bronze Premier - PPO
- Balance by Medica Catastrophic - EPO
- Balance by Medica Catastrophic - PPO
- Balance by Medica Expanded Bronze Standard - EPO
- Balance by Medica Expanded Bronze Standard - PPO
- Balance by Medica Gold $0 Copay PCP Visits - EPO
- Balance by Medica Gold $0 Copay PCP Visits - PPO
- Balance by Medica Gold Share - EPO
- Balance by Medica Gold Share - PPO
- Balance by Medica Gold Standard - EPO
- Balance by Medica Gold Standard - PPO
- Balance by Medica Silver $0 Copay PCP Visits - EPO
- Balance by Medica Silver $0 Copay PCP Visits - PPO
- Balance by Medica Silver Share - EPO
- Balance by Medica Silver Share - PPO
- Balance by Medica Silver Standard - EPO
- Balance by Medica Silver Standard - PPO
- Bronze Classic 4700 (Select) - HMO
- Bronze Classic PCP Saver (Select) - HMO
- Bronze Classic Standard (Select) - HMO
- Gold Classic (Select) - HMO
- Gold Classic Standard (Select) - HMO
- Gold Elite Saver Plus (Select) - HMO
- Secure (Select) - HMO
- Silver Classic Standard (Select) - HMO
- Silver Elite Saver Plus (Select) - HMO
- Silver Simple Chronic Care CKM (Select) - HMO
- Silver Simple PCP Saver (Select) - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with Atrium Health - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with Atrium Health - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with Atrium Health - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard | with Atrium Health - HMO
- Gold Elite Saver Plus - HMO
- Gold Elite Saver Plus | with Atrium Health - HMO
- Secure - HMO
- Secure | with Atrium Health - HMO
- Silver Classic - HMO
- Silver Classic | with Atrium Health - HMO
- Silver Classic Standard - HMO
- Silver Classic Standard | with Atrium Health - HMO
- Silver Simple Diabetes - HMO
- Silver Simple Diabetes | with Atrium Health - HMO
- Silver Simple PCP Saver - HMO
- Silver Simple PCP Saver | with Atrium Health - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 (Select) - HMO
- Bronze Classic PCP Saver Plus Rx Copay (Select) - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard (Choice) - HMO
- Bronze Classic Standard (Select) - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Gold Classic - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard (Choice) - HMO
- Gold Classic Standard (Select) - HMO
- Secure - HMO
- Secure (Choice) - HMO
- Silver Classic Standard - HMO
- Silver Classic Standard (Choice) - HMO
- Silver Classic Standard (Select) - HMO
- Silver Elite Saver Plus - HMO
- Silver Elite Saver Plus Rx Copay (Select) - HMO
- Silver Simple Chronic Care CKM - HMO
- Silver Simple Diabetes (Choice) - HMO
- Bronze Classic - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic 4700 - PPO
- Bronze Classic 4700 | MercyOne - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard - PPO
- Bronze Classic Standard | MercyOne - EPO
- Bronze Elite + PCP Saver - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus - PPO
- Bronze Elite + PCP Saver Plus | MercyOne - EPO
- Gold Classic - EPO
- Gold Classic Standard - EPO
- Gold Classic Standard - PPO
- Gold Classic Standard | MercyOne - EPO
- Gold Elite - EPO
- Gold Elite | MercyOne - EPO
- Gold Elite Saver Plus - EPO
- Secure - EPO
- Secure - PPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Gold Elite Saver Plus - EPO
- Secure - EPO
- Silver Classic Standard - EPO
- Silver Elite - EPO
- Silver Simple Chronic Care CKM - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
- Bronze Classic PCP Saver - HMO
- Bronze Classic Standard - HMO
- Bronze Simple HSA - HMO
- Gold Classic Standard - HMO
- Gold Elite - HMO
- Gold Elite Saver Plus - HMO
- Secure - HMO
- Silver Classic Standard - HMO
- Silver Elite Saver Plus - HMO
- Silver Simple Chronic Care CKM - HMO
- Silver Simple Diabetes - HMO
- Silver Simple PCP Saver - HMO
- Sanford Individual Simplicity $1,750 - PPO
- Sanford Individual Simplicity $3,500 - PPO
- Sanford Individual Simplicity $4,750 - PPO
- Sanford Individual Simplicity $6,000 - PPO
- Sanford Individual Simplicity $7,100 HSA Qualified - PPO
- Sanford Individual Simplicity $9,200 - PPO
- Sanford Individual Simplicity Standardized $1,500 - PPO
- Sanford Individual Simplicity Standardized $5,000 - PPO
- Sanford Individual Simplicity Standardized $7,500 - PPO
- Sanford Individual TRUE $1,750 - HMO
- Sanford Individual TRUE $3,500 - HMO
- Sanford Individual TRUE $4,750 - HMO
- Sanford Individual TRUE $6,000 - HMO
- Sanford Individual TRUE $7,100 HSA Qualified - HMO
- Sanford Individual TRUE $9,200 - HMO
- Sanford Individual TRUE Standardized $1,500 - HMO
- Sanford Individual TRUE Standardized $5,000 - HMO
- Sanford Individual TRUE Standardized $7,500 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 46D0525415
- Facility Type
- Other
- Certificate Effective Date
- January 03, 2025
- Certificate Expiration Date
- January 02, 2027
- Laboratory Director
- DALLAS EARNSHAW MS RN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Utah State Hospital Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 1 | 6 | 2 | 1 | 8 | 4 | 4 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 2 | 6 | 4 | 1 | 16 | 4 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 2 + 6 + 4 + 1 + 1 + 6 + 4 + 8 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1316218449 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316218449, enumerated in the NPI registry as an "organization" on January 20, 2012
The provider is located at 1300 East Center Street Provo, Ut 84606 and the phone number is (801) 344-4601
This medical organization specializes in Pharmacy with taxonomy code 3336I0012X with a focus in Institutional Pharmacy
The provider might be accepting Accepts: Aetna CVS Health, Avera Health Plans, BannerAetna,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 46D0525415 for a "other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on January 20, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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