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Organization
CLEARFIELD JOB CORPS PHARMACY
Active
Organization
CLEARFIELD JOB CORPS PHARMACY
Active
Other names
CLEARFIELD JOB CORPS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LORI HENRY RM (WELLNESS ADMINISTRATOR)
(801) 416-4628
Entity
Organization
Contact information
Practice address
20 W 1700 S, CLEARFIELD, UT 84016-6004
(801) 416-4467
(801) 416-4636
Mailing address
PO BOX 160070, CLEARFIELD, UT 84016-0070
(801) 416-4467
(801) 416-4636
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
1268151704
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4601351
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/22/2006
Last updated
08/07/2009
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