Organization
PARK CITY MARKET INC
Active
Other names
The Market Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HOLM RPH, MBA (PRESIDENT)
(435) 645-7139
Entity
Organization
Contact information
Practice address
1500 SNOW CREEK DR, PARK CITY, UT 84060-7506
(435) 645-7916
(435) 655-7019
Mailing address
PO BOX 26417, SALT LAKE CITY, UT 84126-0417
(801) 978-8225
(801) 978-8634
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
6957464-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4611706
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
870655253003
—
UT
Enumeration date
09/21/2009
Last updated
03/11/2013
Update your record
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