| NPI | 1891715496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAD JOLLEY Owner 801-757-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 5810687-1703) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2018-04-24 |