# SELECT PHARMACY LLC

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

## Provider details

- **NPI number:** 1154795854
- **Authorized official:** ROY PAYNE (PRESIDENT)
- **Authorized official phone:** (801) 759-8981

## Contact information

- **Practice address:** 628 W 7250 S, MIDVALE, UT 84047-1060
- **Practice address phone:** (801) 849-1595
- **Practice address fax:** (801) 895-7450
- **Mailing address:** 628 W 7250 S, MIDVALE, UT 84047-1060
- **Mailing address phone:** (801) 849-1595
- **Mailing address fax:** (801) 895-7450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 9633146-1704 | UT | Yes |

## Other

- **Enumeration date:** 11/18/2015
- **Last updated:** 02/07/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2157509 | PK | — |