Organization
STEWART PHARMACY, LLC
Active
Other names
Stewarts Basin Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON LUKE PHARMD (PHARMACY MANAGER)
(435) 722-2454
Entity
Organization
Contact information
Practice address
245 W HIGHWAY 40, ROOSEVELT, UT 84066-3712
(435) 722-2454
(435) 722-4191
Mailing address
245 W HIGHWAY 40, ROOSEVELT, UT 84066-3712
(435) 722-2454
(435) 722-4191
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9534004-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9534004-1703
STATE LICENSE
UT
Enumeration date
10/12/2015
Last updated
05/05/2016
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