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MOUNTAINLANDS FAMILY PHARMACY - WASATCH
NPI 1861815110
Clinic/Center - Federally Qualified Health Center (FQHC) in Provo, UT

Active since January 22, 2014CLIA 46D2109432 · Waiver
750 N 200 W, SUITE 201, PROVO, UT 84601(801) 429-2000 Get Directions Write a Review

NPPES record last updated: March 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 27, 2025, Mar 25, 2021, Aug 4, 2020 (3 updates tracked since 2020).

About Mountainlands Family Pharmacy - Wasatch NPPES

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

MOUNTAINLANDS FAMILY PHARMACY - WASATCH (NPI 1861815110) is a healthcare organization registered as a federally qualified health center (fqhc) in Provo, Utah and active in the NPI registry since January 2014. The organization holds a CLIA Waiver certificate valid through February 24, 2028 and lists Todd Bailey, Ceo, as its authorized official.

NPPES Registry Identity

NPI1861815110
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameMOUNTAINLANDS FAMILY PHARMACY - WASATCH
Location Address750 N 200 W, SUITE 201Provo, UT 84601-3539
Mailing Address589 S State StProvo, UT 84606-5056 · (801) 429-2020
Phone(801) 429-2000
Organization SubpartYesParent: Mountainlands Comminity Health Center
Authorized OfficialTodd BaileyCeo · (801) 429-2000
Enumeration DateJanuary 22, 2014
Last NPPES UpdateMarch 27, 20253 updates tracked since enumeration
NPPES CertifiedMarch 27, 2025
✔ NPI 1861815110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
750 N 200 W, Provo, UT 84601
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2109432

Mountainlands Family Health Center Wasatch · Provo, UT
Active · expires Feb 24, 2028
CLIA Number46D2109432
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateFebruary 25, 2026
Certificate Expiration DateFebruary 24, 2028
Laboratory DirectorBruce Grover MD
Laboratory Phone(801) 429-2000
Laboratory LocationMountainlands Family Health Center Wasatch750 North 200 West, Suite 201, Provo, UT 84601
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE COSSEY HSW
Case Manager/Care Coordinator
750 N 200 W
PROVO, UT 84601
Utah County (801) 373-4760
LOUIE ALEXANDER HAMNER
Student in an Organized Health Care Education/Training Program
750 N 200 W, SUITE 300
PROVO, UT 84601
Utah County (801) 373-4760
SUNNIE GILES
Student in an Organized Health Care Education/Training Program
750 N 200 W, SUITE 300
PROVO, UT 84601
Utah County (801) 373-4760
KELLY MARIE DALY-WOLFE PA-C, RDN
Physician Assistant (Medical)
750 N 200 W
PROVO, UT 84601
Utah County (801) 429-2000
RISSA ANN HARPER SSW
Case Manager/Care Coordinator
750 N 200 W
PROVO, UT 84601
Utah County (801) 373-4760
JEANNIE IRENE ZWAHLEN HSW
Case Manager/Care Coordinator
750 N 200 W
PROVO, UT 84601
Utah County (801) 373-4760
EMILY MAE GARCIA
Social Worker
750 N 200 W, SUITE NUMBER 300
PROVO, UT 84601
Utah County (801) 373-4760
KELLIE PACK
Student in an Organized Health Care Education/Training Program
750 N 200 W, SUITE 300
PROVO, UT 84601
Utah County (801) 373-4760

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 Mountainlands Family Pharmacy - Wasatch's NPI number?

The NPI number for Mountainlands Family Pharmacy - Wasatch is 1861815110. It was assigned to this organization in the NPPES registry on January 22, 2014.

Where is Mountainlands Family Pharmacy - Wasatch located?

Mountainlands Family Pharmacy - Wasatch is located at 750 N 200 W Suite 201, Provo, UT 84601. The listed phone number is (801) 429-2000.

What is Mountainlands Family Pharmacy - Wasatch's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Mountainlands Family Pharmacy - Wasatch hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2109432) is associated with this NPI, valid through February 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mountainlands Family Pharmacy - Wasatch accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 49 other insurers list Mountainlands Family Pharmacy - Wasatch as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mountainlands Family Pharmacy - Wasatch was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.