Organization
BLUE SPARROW WELLNESS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CODY KIM HANSEN PHARMACIST (OWNER/PHARMACIST IN CHARGE)
(435) 674-0201
Entity
Organization
Contact information
Practice address
558 E RIVERSIDE DR STE 104, ST GEORGE, UT 84790-7176
(435) 674-0201
(435) 674-0217
Mailing address
558 E RIVERSIDE DR STE 104, ST GEORGE, UT 84790-7176
(435) 674-0201
(435) 674-0217
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5725931-1701
UT
Other
Enumeration date
06/30/2017
Last updated
07/21/2022
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