| NPI | 1033264130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEM MCEWEN Pharmacist Manager 435-673-9204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: UT 56416441704) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |