| NPI | 1386430338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK HEBERT Pharmacy Director 801-414-8776 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2025-04-16 |
| Last Update Date | 2025-04-16 |