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Organization

MEDSOURCE RX PHARMACY LLC

Active
Other names
Medsource RX Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
SAHILY PAOLINE (PIC)
(888) 702-2195
Entity
Organization

Contact information

Practice address
9883 S 500 W, SANDY, UT 84070-2561
(801) 727-1979
(855) 332-9272
Mailing address
9883 S 500 W, SANDY, UT 84070-2561
(801) 727-0080
(855) 332-9272

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
7609917-1703
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2123919
PK
Enumeration date
03/16/2010
Last updated
10/11/2013
About Stedi
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