Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mountainlands Family Pharmacy - Wasatch

Organization Federally Qualified Health Center (FQHC) · NPI 1861815110

Mountainlands Family Pharmacy - Wasatch is a Federally Qualified Health Center (FQHC) in Provo, Utah. Licensed in Utah. Registered with an NPI since 2014.

Licensed in
UT
In the registry since
2014
Specialties on file
2

Practice location Address checks out

750 N 200 W Ste 201
Provo, UT 84601-3539
Phone: (801) 429-2000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X
Community/Retail Pharmacy Taxonomy 3336C0003X (UT)

Record details

NPI number1861815110
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMountainlands Comminity Health Center
Authorized official Todd Bailey — Ceo · (801) 429-2000
NPI enumeratedJanuary 22, 2014
Last updated in NPPESMarch 27, 2025
Certification dateMarch 27, 2025
Mailing address589 S State St, Provo, UT 84606-5056

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