# SUPER DRUG & HERBAL STORE, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lennys Richfield Family Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053689158
- **Authorized official:** LEONARD FITZGERALD (OWNER/PRESIDENT)
- **Authorized official phone:** (435) 896-6000

## Contact information

- **Practice address:** 508 N MAIN ST, RICHFIELD, UT 84701-1864
- **Practice address phone:** (435) 896-6000
- **Practice address fax:** (435) 896-1975
- **Mailing address:** 508 N MAIN ST, RICHFIELD, UT 84701-1864
- **Mailing address phone:** (435) 896-6000
- **Mailing address fax:** (435) 896-1975

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 10579480-1703 | UT | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 12/05/2011
- **Last updated:** 11/10/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1053689158 | — | UT |
| 01 | — | 2133086 | PK | — |