Organization
SAN JUAN PHARMACY INC
Active
Other names
SAN JUAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DANA NIELSON (PHARMACIST)
(435) 678-2781
Entity
Organization
Contact information
Practice address
65 S MAIN ST, BLANDING, UT 84511-3742
(435) 678-2781
(435) 678-2379
Mailing address
65 S MAIN ST, BLANDING, UT 84511-3742
(435) 678-2781
(435) 678-2379
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1271021703
UT
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2106938
PK
—
Enumeration date
09/30/2006
Last updated
11/03/2016
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