# PROFESSIONAL PLAZA PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PROFESSIONAL PLAZA PHARMACY, INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316958804
- **Authorized official:** GEORGE HAMBLIN (PRESIDENT)
- **Authorized official phone:** (801) 773-3863

## Contact information

- **Practice address:** 2065 N ROBBINS DR, LAYTON, UT 84041-1133
- **Practice address phone:** (801) 773-3863
- **Practice address fax:** (801) 773-3892
- **Mailing address:** 2065 N ROBBINS DR, LAYTON, UT 84041-1133
- **Mailing address phone:** (801) 773-3863
- **Mailing address fax:** (801) 773-3892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 1335541703 | UT | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 10/17/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2107760 | PK | — |