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Organization
MT NEBO THRIFT CORP
Active
Organization
MT NEBO THRIFT CORP
Active
Other names
MT NEBO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD MEASOM (RX SUPERVISOR)
(801) 465-2347
Entity
Organization
Contact information
Practice address
965 N MAIN ST, NEPHI, UT 84648
(435) 623-2183
(435) 623-4237
Mailing address
965 N MAIN ST, NEPHI, UT 84648-1003
(435) 623-2183
(435) 623-4237
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
8963467-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649697244
—
UT
01
—
2145208
PK
—
Enumeration date
03/21/2014
Last updated
06/18/2018
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