Organization
UNIVERSITY OF UTAH
Active
Other names
CENTERVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEE K HOWELL CPHT (PHARMACY BUSINESS OPERATION MANAGER)
(801) 587-6334
Entity
Organization
Contact information
Practice address
26 S MAIN ST, STE 100, CENTERVILLE, UT 84014-1817
(801) 693-7950
(801) 693-7955
Mailing address
PO BOX 841208, LOS ANGELES, CA 90084-1208
(801) 587-6334
(801) 587-2996
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
62502141703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100899
PK
—
01
—
4610588
NCPDP
—
Enumeration date
10/12/2006
Last updated
03/16/2021
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