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Organization

LION PRIDE PHARMACY AND WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICAH KEALOHA HARWARD PHARMD (MEMBER/ PHARMAIST IN CHARGE)
(435) 628-2066
Entity
Organization

Contact information

Practice address
163 W 1600 S STE 3, SAINT GEORGE, UT 84770-6715
(435) 628-2066
(435) 623-2887
Mailing address
163 W 1600 S STE 3, SAINT GEORGE, UT 84770-6715
(435) 628-2066
(435) 623-2887

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
332BC3200X
Customized Equipment (DME)
3336C0003X
Community/Retail Pharmacy
Primary
3336C0004X
Compounding Pharmacy
3336M0002X
Mail Order Pharmacy
3336S0011X
Specialty Pharmacy
335E00000X
Prosthetic/Orthotic Supplier
335G00000X
Medical Foods Supplier

Other

Enumeration date
03/14/2022
Last updated
03/14/2022
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