Organization
SOUTH VALLEY COMPOUNDING PHARMACY LLC
Active
Other names
South Valley Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BART SMITH PHARM D (PHAMACIST/OWNER)
(801) 676-7880
Entity
Organization
Contact information
Practice address
3796 W 12600 S, RIVERTON, UT 84065-7215
(801) 676-7880
(801) 676-7883
Mailing address
3796 W 12600 S, RIVERTON, UT 84065-7215
(801) 676-7880
(801) 676-7883
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9436474-1703
UT
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013148071
—
UT
01
—
2121956
PK
—
Enumeration date
08/06/2009
Last updated
10/02/2021
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