# FAMILY PLAZA PHARMACY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY PLAZA PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831171941
- **Authorized official:** SHANE JENSEN PHARMD (OWNER)
- **Authorized official phone:** (801) 569-0175

## Contact information

- **Practice address:** 3570 W 9000 S, STE 150, WEST JORDAN, UT 84088-8869
- **Practice address phone:** (801) 569-0175
- **Practice address fax:** (801) 569-8941
- **Mailing address:** 3570 W 9000 S, STE 150, WEST JORDAN, UT 84088-8869
- **Mailing address phone:** (801) 569-0175
- **Mailing address fax:** (801) 569-6941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 6732558-1703 | UT | Yes |

## Other

- **Enumeration date:** 11/15/2005
- **Last updated:** 08/12/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2099816 | PK | — |