# UNIVERSITY OF UTAH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CENTERVILLE PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104915792
- **Authorized official:** KELLEE K HOWELL CPHT (PHARMACY BUSINESS OPERATION MANAGER)
- **Authorized official phone:** (801) 587-6334

## Contact information

- **Practice address:** 26 S MAIN ST, STE 100, CENTERVILLE, UT 84014-1817
- **Practice address phone:** (801) 693-7950
- **Practice address fax:** (801) 693-7955
- **Mailing address:** PO BOX 841208, LOS ANGELES, CA 90084-1208
- **Mailing address phone:** (801) 587-6334
- **Mailing address fax:** (801) 587-2996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 62502141703 | UT | Yes |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 03/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2100899 | PK | — |
| 01 | — | 4610588 | NCPDP | — |