# UNIVERSITY OF UTAH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Jordan Daybreak Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275838575
- **Authorized official:** MICHAEL KELLY (PHARMACY SRV. DIRECTOR)
- **Authorized official phone:** (801) 587-6325

## Contact information

- **Practice address:** 4696 DAYBREAK RIM WAY, SOUTH JORDAN, UT 84095-5129
- **Practice address phone:** (801) 213-4550
- **Practice address fax:** (801) 213-4555
- **Mailing address:** 4696 DAYBREAK RIM WAY, SOUTH JORDAN, UT 84095-5129
- **Mailing address phone:** (801) 213-4550
- **Mailing address fax:** (801) 213-4555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 7824017-1703 | UT | Yes |

## Other

- **Enumeration date:** 01/18/2011
- **Last updated:** 03/29/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4611922 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |