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MOBILE VIVITROL, LLC
NPI 1033742994
Family Medicine - Addiction Medicine in Draper, UT

Active since February 19, 2020
13032 SNOW CREST CR, DRAPER, UT 84020(801) 898-7778 Get Directions Write a Review

NPPES record last updated: March 12, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 12, 2021, Feb 19, 2020 (2 updates tracked since 2020).

About Mobile Vivitrol, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOBILE VIVITROL, LLC (NPI 1033742994) is a healthcare organization registered as an addiction medicine in Draper, Utah and active in the NPI registry since February 2020. The organization lists Mark G. Richards, Owner, as its authorized official.

NPPES Registry Identity

NPI1033742994
Entity TypeOrganization
Primary Taxonomy207QA0401X
Legal Business NameMOBILE VIVITROL, LLC
Location Address13032 SNOW CREST CRDraper, UT 84020
Mailing AddressPo Box 639Draper, UT 84020 · (801) 558-6564
Phone(801) 898-7778
Organization SubpartNo
Authorized OfficialMark G. RichardsOwner · (801) 898-7778
Enumeration DateFebruary 19, 2020
Last NPPES UpdateMarch 12, 20212 updates tracked since enumeration
NPPES CertifiedMarch 12, 2021
✔ NPI 1033742994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0401X
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
13032 SNOW CREST CR, Draper, UT 84020
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mobile Vivitrol, LLC's NPI number?

The NPI number for Mobile Vivitrol, LLC is 1033742994. It was assigned to this organization in the NPPES registry on February 19, 2020.

Where is Mobile Vivitrol, LLC located?

Mobile Vivitrol, LLC is located at 13032 Snow Crest Cr, Draper, UT 84020. The listed phone number is (801) 898-7778.

What is Mobile Vivitrol, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

When was this NPI record last updated?

The NPPES record for Mobile Vivitrol, LLC was last updated on March 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.