| NPI | 1992027098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS S BURGOYNE President 801-865-1997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: UT 2755631701) |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2010-02-17 |