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Organization

ROOTS PHARMACEUTICALS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE ROOTSAERT PHARMD RPH (PRESIDENT)
(559) 760-2934
Entity
Organization

Contact information

Practice address
12 W 100 N, STE 201B, AMERICAN FORK, UT 84003-1611
(559) 760-2934
(559) 756-7600
Mailing address
12 W 100 N, STE 201B, AMERICAN FORK, UT 84003-1611

Taxonomy

Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
60531781703
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4610451
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
06/22/2006
Last updated
02/20/2008
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