| NPI | 1295483782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH KEALOHA HARWARD Member/ Pharmaist In Charge 435-628-2066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| 335G00000X Medical Foods Supplier | |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2022-03-14 |