# KWIK STOP DRUG

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KWIK STOP DRUG
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295765204
- **Authorized official:** TERRY VAN VLEET (OWNER AND PRESIDENT)
- **Authorized official phone:** (801) 399-5866

## Contact information

- **Practice address:** 325 36TH ST, OGDEN, UT 84405-1623
- **Practice address phone:** (801) 399-5866
- **Practice address fax:** (801) 621-4791
- **Mailing address:** 325 36TH ST, OGDEN, UT 84405-1623
- **Mailing address phone:** (801) 399-5866
- **Mailing address fax:** (801) 621-4791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 321208-1703 | UT | Yes |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 10/05/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4600450 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |