Organization
75 MDG PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS COSENTINO RPH (PHARMACY FLIGHT COMMANDER)
(801) 586-9529
Entity
Organization
Contact information
Practice address
7321 11TH ST BLDG 570, HILL AFB, UT 84056-5012
(801) 777-0419
(801) 586-9890
Mailing address
7321 11TH ST BLDG 570, HILL AFB, UT 84056-5012
(801) 777-0419
(801) 586-9890
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4609268
NCPDP
—
Enumeration date
12/21/2006
Last updated
06/13/2008
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