NPI | 1083134183 |
---|---|
Doing Business As | INTERMOUNTAIN PHARMACY #533 |
Entity Type | Organization |
Authorized Contact | NANNETTE BERENSEN Vice President Of Clinical Syst EMS 801-284-1005 |
Organization Subpart ? | Yes |
Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: UT 10389313-1703) |
Additional Taxonomies | 333600000X Pharmacy |
3336C0004X Pharmacy Compounding Pharmacy | |
Enumeration Date | 2017-06-21 |
Last Update Date | 2018-07-27 |