# TIBBITTS FAMILY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tibbitts Family Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952657934
- **Authorized official:** BRETT TIBBITTS (OWNER/PHARMACIST-IN-CHARGE)
- **Authorized official phone:** (801) 771-0363

## Contact information

- **Practice address:** 2940 N CHURCH ST STE 201, LAYTON, UT 84040-6503
- **Practice address phone:** (801) 771-0363
- **Practice address fax:** (801) 771-0506
- **Mailing address:** 2940 N CHURCH ST STE 201, LAYTON, UT 84040-6503
- **Mailing address phone:** (801) 771-0363
- **Mailing address fax:** (801) 771-0506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 8393226-1703 | UT | Yes |

## Other

- **Enumeration date:** 07/27/2012
- **Last updated:** 01/15/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4612265 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |