Organization
MIDTOWN COMMUNITY HEALTH CENTER INC
Active
Other names
MIDTOWN COMMUNITY HEALTH CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA MARTINEZ BSPHARM (EXECUTIVE DIRECTOR)
(801) 334-1321
Entity
Organization
Contact information
Practice address
2240 ADAMS AVE, OGDEN, UT 84401-1511
(801) 395-8200
(801) 436-1015
Mailing address
2240 ADAMS AVE, OGDEN, UT 84401-1511
(801) 395-8200
(801) 436-1015
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
61891751704
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100848
PK
—
Enumeration date
08/21/2006
Last updated
04/20/2017
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