| NPI | 1629454772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL RICHARDS Owner 801-316-0790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 9471212-1703) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2016-06-17 |