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Organization
SAN JUAN PHARMACY INC
Active
Organization
SAN JUAN PHARMACY INC
Active
Other names
SAN JUAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DANA NIELSON (PHARMACIST)
(435) 678-2781
Entity
Organization
Contact information
Practice address
65 S MAIN ST, BLANDING, UT 84511-3742
(435) 678-2781
(435) 678-2379
Mailing address
65 S MAIN ST, BLANDING, UT 84511-3742
(435) 678-2781
(435) 678-2379
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
1271021703
UT
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2106938
PK
—
Enumeration date
09/30/2006
Last updated
11/03/2016
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