| NPI | 1255659470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN ERICKSON Owner/Pharmacist 801-255-7666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: UT 5906468-1703) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2010-12-28 |