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Organization
PC PHARMACY AT THE CLINIC INC
Active
Organization
PC PHARMACY AT THE CLINIC INC
Active
Other names
PARK CITY PHCY AT THE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY BLACK (OWNER)
(435) 658-5051
Entity
Organization
Contact information
Practice address
1665 BONANZA DR, PARK CITY, UT 84060
(435) 658-5051
(435) 658-5093
Mailing address
PO BOX 680772, PARK CITY, UT 84068-0772
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
60427351703
UT
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4609547
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/18/2006
Last updated
09/11/2025
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