Organization
UNIVERSITY OF UTAH
Active
Other names
South Jordan Daybreak Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KELLY (PHARMACY SRV. DIRECTOR)
(801) 587-6325
Entity
Organization
Contact information
Practice address
4696 DAYBREAK RIM WAY, SOUTH JORDAN, UT 84095-5129
(801) 213-4550
(801) 213-4555
Mailing address
4696 DAYBREAK RIM WAY, SOUTH JORDAN, UT 84095-5129
(801) 213-4550
(801) 213-4555
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
7824017-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4611922
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/18/2011
Last updated
03/29/2011
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