# CANYON PHARMACEUTICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rock Canyon Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346282951
- **Authorized official:** RYAN JOHANSEN (OWNER)
- **Authorized official phone:** (801) 440-2995

## Contact information

- **Practice address:** 3179 N CANYON RD, PROVO, UT 84604-3916
- **Practice address phone:** (801) 377-2002
- **Practice address fax:** (801) 377-2007
- **Mailing address:** 3179 N CANYON RD, PROVO, UT 84604-3916
- **Mailing address phone:** (801) 377-2002
- **Mailing address fax:** (801) 377-2007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 50843661703 | UT | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/11/2006
- **Last updated:** 08/15/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 710871500008 | — | UT |