| NPI | 1912341256 |
|---|---|
| Doing Business As | PROVO CANYON PHARMACY |
| Entity Type | Organization |
| Authorized Contact | STEVE HIGHT Pharmacy Director 801-852-3859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: UT 83428331704) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2014-03-06 |