Organization
SKIN CARE RX L L C
Active
Other names
Skin Care Rx LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LOLA PORTER (PIC)
(801) 924-3927
Entity
Organization
Contact information
Practice address
1055 S 700 W, SALT LAKE CITY, UT 84104-1504
(801) 924-3927
(801) 924-5822
Mailing address
1055 S 700 W, SALT LAKE CITY, UT 84104-1504
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
7076211-1704
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4611201
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/13/2009
Last updated
02/13/2009
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