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Organization
PANGUITCH DRUG CORP
Active
Organization
PANGUITCH DRUG CORP
Active
Other names
PANGUITCH DRUG CO
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE MARSHALL RPH (OWNER)
(435) 676-2212
Entity
Organization
Contact information
Practice address
95 E CENTER, PANGUITCH, UT 84759-0068
(435) 676-2212
(435) 676-8850
Mailing address
PO BOX 68, PANGUITCH, UT 84759-0068
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
3417951703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4601894
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
870287657001
—
UT
Enumeration date
11/08/2005
Last updated
02/24/2011
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