| NPI | 1568746410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN KEITH ANDERSON Executive Director 801-410-1980 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2011-10-10 |