# MARCHANTS PHARM WAGON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Santaquin Pharmacy & Diabetes Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912403502
- **Authorized official:** DR. KEVIN SCOTT MARCHANT PHARM.D. (OWNER/MANAGER)
- **Authorized official phone:** (435) 691-4288

## Contact information

- **Practice address:** 390 E MAIN ST, SANTAQUIN, UT 84655-7078
- **Practice address phone:** (801) 754-1141
- **Practice address fax:** (801) 754-3141
- **Mailing address:** 390 E MAIN ST, SANTAQUIN, UT 84655-7078
- **Mailing address phone:** (801) 754-1141
- **Mailing address fax:** (801) 754-3141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 10701041 | UT | Yes |

## Other

- **Enumeration date:** 04/02/2018
- **Last updated:** 02/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1912403502 | — | UT |