| NPI | 1316532500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE LEE KROEGER Pharmacy Technician 435-723-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2021-03-09 |