| NPI | 1932084159 |
|---|---|
| Doing Business As | 72ND STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JENNIFER THOMAS CEO 801-891-4094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-08-07 |
| Last Update Date | 2025-08-07 |