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Organization
ASSOCIATED FRESH MARKETS INC
Active
Organization
ASSOCIATED FRESH MARKETS INC
Active
Other names
Fresh Market Pharmacy #2312
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA HANSON PHARMD (DIRECTOR, PHARMACY OPERATIONS)
(801) 978-8309
Entity
Organization
Contact information
Practice address
560 W CENTER ST, PROVO, UT 84601-4276
(801) 374-1704
(801) 374-0964
Mailing address
PO BOX 26908, SALT LAKE CITY, UT 84126-0908
(801) 978-8225
(801) 978-8634
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
7442351-1703
UT
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427381714
—
UT
01
—
2121823
PK
—
Enumeration date
09/17/2009
Last updated
04/05/2016
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