| NPI | 1982711693 |
|---|---|
| Doing Business As | INTERMOUNTAIN PHARMACY #128 |
| Entity Type | Organization |
| Authorized Contact | NANNETTE BERENSEN VP COO Shared Clinical Services 801-507-8002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2022-01-24 |