| NPI | 1437849239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN HORNE Pharmacist In Charge 801-809-2656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-05-15 |