| NPI | 1356458079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANNETTE BERENSEN Vice President Of Clinical Systems 801-284-1005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 56346761703) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2018-05-04 |