Organization
BADGER MANAGEMENT LLC
Active
Other names
Lee's MarketPlace - Foxboro Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BADGER (MEMBER/MANAGER/PRESIDENT/AO)
(435) 774-4150
Entity
Organization
Contact information
Practice address
725 N REDWOOD ROAD, N SALT LAKE, UT 84054
(385) 322-7900
(385) 322-7966
Mailing address
505 E 1400 N, SUITE 110, LOGAN, UT 84341-2486
(435) 774-4150
(435) 774-4166
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
10121455-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166235
PK
—
Enumeration date
11/18/2016
Last updated
03/23/2017
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