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Organization
WEST GORDON PHARMACY INC
Active
Organization
WEST GORDON PHARMACY INC
Active
Other names
West Gordon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BURNETT (SECRETARY)
(435) 512-2102
Entity
Organization
Contact information
Practice address
3225 W GORDON AVE STE 2, LAYTON, UT 84041-5728
(801) 544-7979
(801) 682-8011
Mailing address
3225 W GORDON AVE STE 2, LAYTON, UT 84041-5728
(801) 544-7979
(801) 682-8011
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9221852-1703
UT
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528464336
—
UT
01
—
2149549
PK
—
Enumeration date
11/06/2014
Last updated
12/03/2019
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