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Organization

PC PHARMACY AT THE CLINIC INC

Active
Other names
PARK CITY PHCY AT THE CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTY BLACK (OWNER)
(435) 658-5051
Entity
Organization

Contact information

Practice address
1665 BONANZA DR, PARK CITY, UT 84060
(435) 658-5051
(435) 658-5093
Mailing address
PO BOX 680772, PARK CITY, UT 84068-0772

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
60427351703
UT
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4609547
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
08/18/2006
Last updated
09/11/2025
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