| NPI | 1811406218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL RICHARDS Owner 801-506-6999 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 1051155-1073) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2017-09-28 |