# JW2 LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Desert Canyon Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134895543
- **Authorized official:** TRAVIS JACKMAN PHARM D (OWNER/ PIC)
- **Authorized official phone:** (435) 900-1008

## Contact information

- **Practice address:** 922 E BRIGHAM RD BLDG 4D, ST GEORGE, UT 84790-8751
- **Practice address phone:** (435) 900-1008
- **Practice address fax:** (435) 900-1009
- **Mailing address:** 922 E BRIGHAM RD BLDG 4D, ST GEORGE, UT 84790-8751
- **Mailing address phone:** (435) 900-1008
- **Mailing address fax:** (435) 900-1009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/17/2021
- **Last updated:** 08/17/2021