Organization
BASIN FAMILY PHARMACY
Active
Other names
BASIN FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LUKE RPH (OWNER)
(435) 722-2454
Entity
Organization
Contact information
Practice address
245 W HIGHWAY 40, ROOSEVELT, UT 84066-3712
(435) 722-2454
(435) 722-4191
Mailing address
245 W HIGHWAY 40, ROOSEVELT, UT 84066-3712
(435) 722-2454
(435) 722-4191
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4905987-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2106870
PK
—
Enumeration date
09/14/2006
Last updated
09/10/2013
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