# FAMILY PLAZA PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609493667
- **Authorized official:** SHANE MICHAEL JENSEN PHARMD (PRESIDENT)
- **Authorized official phone:** (801) 569-0175

## Contact information

- **Practice address:** 3570 W 9000 S STE 150, WEST JORDAN, UT 84088-8872
- **Practice address phone:** (801) 569-0175
- **Practice address fax:** (801) 569-8941
- **Mailing address:** 3570 W 9000 S STE 150, WEST JORDAN, UT 84088-8872
- **Mailing address phone:** (801) 569-0175
- **Mailing address fax:** (801) 569-8941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/25/2020
- **Last updated:** 06/25/2020