| NPI | 1194831552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA MARTINEZ Executive Director 801-334-1321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy (Licence: UT 61891751704) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2017-04-20 |