Individual
CHARLES DESANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
VA SALT LAKE CITY HEALTH CARE SYSTEM, PHARMACY (119), SALT LAKE CITY, UT 84148-0001
(801) 582-1565
(801) 584-2530
Mailing address
150 S 300 E APT 303, SALT LAKE CITY, UT 84111-2082
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
151627-1701
UT
Other
Enumeration date
07/11/2006
Last updated
07/08/2007
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