SOUTH JORDAN PHARMACY – Community/Retail Pharmacy, NPI 1578652160
Community/Retail Pharmacy
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SOUTH JORDAN PHARMACY
PO BOX 511124
SALT LAKE CITY, UT 841511124
Phone: (801) 587-6325
Fax: (801) 585-1808
Type: Mailing
PO BOX 841208
LOS ANGELES, CA 900841208
Phone: (801) 587-6334
Fax: (801) 587-2996
Type: Mailing
Johnson Elite Orthodontics, 4775 W, Daybreak Parkway, Rio Tinto Office, Daybreak Community, South Jordan, Salt Lake County, Utah, 84095, United States
ROOM 101
SOUTH JORDAN, UT 840095994
Phone: (801) 213-4550
Fax: (801) 213-4555
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | 100 | 100 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 97 | 97 | $0 |
| 90480 | Admn sarscov2 vacc 1 dose | 93 | 93 | $0 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | 93 | 93 | $0 |
| 0124A | Adm sarscv2 bvl 30mcg/.3ml a | 16 | 16 | $0 |
Insurance plans in this area (ZIP 84151)
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