# PARK CITY MARKET INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** The Market Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083948210
- **Authorized official:** MICHAEL HOLM RPH, MBA (PRESIDENT)
- **Authorized official phone:** (435) 645-7139

## Contact information

- **Practice address:** 1500 SNOW CREEK DR, PARK CITY, UT 84060-7506
- **Practice address phone:** (435) 645-7916
- **Practice address fax:** (435) 655-7019
- **Mailing address:** PO BOX 26417, SALT LAKE CITY, UT 84126-0417
- **Mailing address phone:** (801) 978-8225
- **Mailing address fax:** (801) 978-8634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 6957464-1703 | UT | Yes |

## Other

- **Enumeration date:** 09/21/2009
- **Last updated:** 03/11/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4611706 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |
| 05 | — | 870655253003 | — | UT |