| NPI | 1932404126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDY TSAPATSARIS Executive Director 801-410-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: UT 7819376-1704) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2016-12-07 |