| NPI | 1033199666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM E DOMAN Controller 801-263-5442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: UT 8021342-1703) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: UT 5738699-1703) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 5738699-1703) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2023-03-07 |