| NPI | 1316330749 |
|---|---|
| Doing Business As | REVERE HEALTH |
| Other Name | ONCOLOGY PHARMACY |
| Other Name | ONCOLOGY DISPENSING MEDICAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | JED HARSTON Director Of Managed Care 801-812-5012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: UT 9847128-1725) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2018-06-16 |