# LION PRIDE PHARMACY AND WELLNESS

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

## Provider details

- **NPI number:** 1295483782
- **Authorized official:** MR. MICAH KEALOHA HARWARD PHARMD (MEMBER/ PHARMAIST IN CHARGE)
- **Authorized official phone:** (435) 628-2066

## Contact information

- **Practice address:** 163 W 1600 S STE 3, SAINT GEORGE, UT 84770-6715
- **Practice address phone:** (435) 628-2066
- **Practice address fax:** (435) 623-2887
- **Mailing address:** 163 W 1600 S STE 3, SAINT GEORGE, UT 84770-6715
- **Mailing address phone:** (435) 628-2066
- **Mailing address fax:** (435) 623-2887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |
| 335G00000X | Medical Foods Supplier | — | NULL | — |

## Other

- **Enumeration date:** 03/14/2022
- **Last updated:** 03/14/2022