| NPI | 1235918962 |
|---|---|
| Doing Business As | PORTAL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ZACH WOJCIESZEK CFO 435-719-3558 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2024-04-23 |