Organization
UTAH STATE HOSPITAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALLAS L. EARNSHAW (SUPERINTENDENT)
(801) 344-4200
Entity
Organization
Contact information
Practice address
1300 EAST CENTER STREET, PROVO, UT 84606-3554
(801) 344-4601
(801) 344-4604
Mailing address
PO BOX 270, PROVO, UT 84603-0270
(801) 344-4601
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
—
—
Other
Enumeration date
01/20/2012
Last updated
07/25/2019
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