| NPI | 1093803215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN NICHOLS Owner 801-302-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: UT 8184721-1704) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2014-07-02 |