# SOUTH VALLEY COMPOUNDING PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Valley Compounding Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013148071
- **Authorized official:** BART SMITH PHARM D (PHAMACIST/OWNER)
- **Authorized official phone:** (801) 676-7880

## Contact information

- **Practice address:** 3796 W 12600 S, RIVERTON, UT 84065-7215
- **Practice address phone:** (801) 676-7880
- **Practice address fax:** (801) 676-7883
- **Mailing address:** 3796 W 12600 S, RIVERTON, UT 84065-7215
- **Mailing address phone:** (801) 676-7880
- **Mailing address fax:** (801) 676-7883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9436474-1703 | UT | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/06/2009
- **Last updated:** 10/02/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1013148071 | — | UT |
| 01 | — | 2121956 | PK | — |