| NPI | 1740692367 |
|---|---|
| Doing Business As | A&W PHARMACY |
| Entity Type | Organization |
| Authorized Contact | WADE POULSON Owner, PIC 435-738-3784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 89320161703) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2015-01-26 |