| NPI | 1063051761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAY DON BINGHAM Pharmacist In Charge 801-331-6630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2020-03-12 |