# PHARMACY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FIVE STAR SPECIALTY PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093803215
- **Authorized official:** BRYAN NICHOLS (OWNER)
- **Authorized official phone:** (801) 302-8555

## Contact information

- **Practice address:** 2235 S 1300 W STE D, SALT LAKE CITY, UT 84119-7242
- **Practice address phone:** (801) 302-8555
- **Practice address fax:** (801) 302-8600
- **Mailing address:** PO BOX 26667, SALT LAKE CITY, UT 84126-0667
- **Mailing address phone:** (801) 302-8555
- **Mailing address fax:** (801) 302-8600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 8184721-1704 | UT | Yes |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 07/02/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2101153 | PK | — |