NPI | 1912376849 |
---|---|
Doing Business As | WESTSIDE HEALTH MART |
Entity Type | Organization |
Authorized Contact | HAL ROE Owner,PIC,AO 801-698-2497 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 95330441703) |
Additional Taxonomies | 333600000X Pharmacy |
3336C0004X Pharmacy, Compounding Pharmacy | |
Enumeration Date | 2015-09-22 |
Last Update Date | 2022-03-15 |