Organization
JW2 LLC
Active
Other names
Desert Canyon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS JACKMAN PHARM D (OWNER/ PIC)
(435) 900-1008
Entity
Organization
Contact information
Practice address
922 E BRIGHAM RD BLDG 4D, ST GEORGE, UT 84790-8751
(435) 900-1008
(435) 900-1009
Mailing address
922 E BRIGHAM RD BLDG 4D, ST GEORGE, UT 84790-8751
(435) 900-1008
(435) 900-1009
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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