| NPI | 1215035969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY DURRANT Owner Pharmacist 435-563-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID 1336CP) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ID P4557) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID 1336CP) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |