| NPI | 1497890099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG C VAN TASSELL Owner Pharmacist 435-783-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: UT 0285417220) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2008-06-18 |