# SPANISH FORK COMMUNITY PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255870564
- **Authorized official:** BRENT K WARREN (PRESIDENT)
- **Authorized official phone:** (801) 361-1000

## Contact information

- **Practice address:** 375 W. CENTER, SPANISH FORK, UT 84660
- **Practice address phone:** (801) 361-1000
- **Mailing address:** 375 W. CENTER, SPANISH FORK, UT 84660
- **Mailing address phone:** (801) 361-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/20/2017
- **Last updated:** 02/20/2017
