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Organization
SOUTH VALLEY COMPOUNDING PHARMACY LLC
Active
Organization
SOUTH VALLEY COMPOUNDING PHARMACY LLC
Active
Other names
South Valley Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BART SMITH PHARM D (PHAMACIST/OWNER)
(801) 676-7880
Entity
Organization
Contact information
Practice address
3796 W 12600 S, RIVERTON, UT 84065-7215
(801) 676-7880
(801) 676-7883
Mailing address
3796 W 12600 S, RIVERTON, UT 84065-7215
(801) 676-7880
(801) 676-7883
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
9436474-1703
UT
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013148071
—
UT
01
—
2121956
PK
—
Enumeration date
08/06/2009
Last updated
10/02/2021
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