| NPI | 1790892404 |
|---|---|
| Doing Business As | PRIMARY CHILDRENS OUTPATIENT PHARMACY |
| Entity Type | Organization |
| Authorized Contact | NANNETTE BERENSEN Vice President Of Clinical Systems 801-507-8002 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 49062421703) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-02-21 |