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Organization

TERRACE PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALAN V WINTER (OWNER/PHARMACIST)
(801) 479-9645
Entity
Organization

Contact information

Practice address
5167 ADAMS AVE, #B, OGDEN, UT 84405-4522
(801) 479-9645
(801) 475-6404
Mailing address
5167 ADAMS AVE, #B, OGDEN, UT 84405-4522
(801) 479-9645
(801) 475-6404

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
7572230-1703
UT
3336C0003X
Community/Retail Pharmacy
Primary
7872230-8913
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
528962785009
UT
Enumeration date
10/03/2006
Last updated
05/03/2010
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