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Organization
KOHLERS FOOD STORES PHAMACY
Active
Organization
KOHLERS FOOD STORES PHAMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES RICHARD WILLIE PHARMACIST (HEAD PHARMACIST)
(801) 756-2250
Entity
Organization
Contact information
Practice address
5353 W 11000 N, HIGHLAND, UT 84003-9403
(801) 756-2250
Mailing address
5353 W 11000 N, HIGHLAND, UT 84003-9403
(801) 756-2250
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
274777-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870309253012
—
UT
Enumeration date
01/02/2006
Last updated
08/22/2020
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