# APOTHECARY SHOP OF SANDY INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** APOTHECARY HOLDINGS INC
- **Other names:** SOUTHWOOD APOTHECARY SHOP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639100803
- **Legal business name:** APOTHECARY HOLDINGS INC
- **Authorized official:** NATHAN DOWNHOUR PHRMD (VP OF OPERATIONS)
- **Authorized official phone:** (623) 434-3654

## Contact information

- **Practice address:** 880 E 9400 S, STE 118, SANDY, UT 84094-3667
- **Practice address phone:** (801) 571-0340
- **Practice address fax:** (801) 576-8938
- **Mailing address:** 1606 W WHISPERING WIND DR, PHOENIX, AZ 85085-0678
- **Mailing address phone:** (623) 434-3659
- **Mailing address fax:** (623) 434-3673

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 69707811703 | UT | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/06/2006
- **Last updated:** 11/06/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4603165 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |
| 01 | — | 67629 | MEDICARE - MASS IMMUNIZATION ROSTER BILLER | — |
| 05 | — | 8703064560008 | — | UT |