Organization
SUPER DRUG & HERBAL STORE, INC
Active
Other names
Lennys Richfield Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD FITZGERALD (OWNER/PRESIDENT)
(435) 896-6000
Entity
Organization
Contact information
Practice address
508 N MAIN ST, RICHFIELD, UT 84701-1864
(435) 896-6000
(435) 896-1975
Mailing address
508 N MAIN ST, RICHFIELD, UT 84701-1864
(435) 896-6000
(435) 896-1975
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
10579480-1703
UT
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053689158
—
UT
01
—
2133086
PK
—
Enumeration date
12/05/2011
Last updated
11/10/2021
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