| NPI | 1174390520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA KIP HANSON Vice President Of Pharmacy 801-978-8309 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2024-04-24 |