| NPI | 1952158982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARISSA SORENSEN MONROY Medical Officer 801-359-2256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy |
| Additional Taxonomies | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-05-06 |