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Organization
STEWART PHARMACY, LLC
Active
Organization
STEWART PHARMACY, LLC
Active
Other names
Stewarts Basin Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON LUKE PHARMD (PHARMACY MANAGER)
(435) 722-2454
Entity
Organization
Contact information
Practice address
245 W HIGHWAY 40, ROOSEVELT, UT 84066-3712
(435) 722-2454
(435) 722-4191
Mailing address
245 W HIGHWAY 40, ROOSEVELT, UT 84066-3712
(435) 722-2454
(435) 722-4191
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9534004-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9534004-1703
STATE LICENSE
UT
Enumeration date
10/12/2015
Last updated
05/05/2016
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