Organization
UINTAH BASIN MEDICAL CENTER
Active
Other names
Duchesne Valley Medical Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT HALES (CFO)
(435) 722-6164
Entity
Organization
Contact information
Practice address
50 EAST 200 SOUTH, DUCHESNE, UT 84021
(435) 738-5403
(435) 738-5405
Mailing address
PO BOX 905, 50 EAST 200 SOUTH, DUCHESNE, UT 84021-0905
(435) 738-5403
(435) 738-5405
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
7263753-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4611249
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/05/2009
Last updated
10/22/2025
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