| NPI | 1063825438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY WARDLE Pharmacy Manager 801-426-6650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 71165221701) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |