Organization
UINTAH BASIN MEDICAL CENTER INC
Active
Parent organization
UINTAH BASIN MEDICAL CENTER INC
Other names
Uintah Basin Medical Center Outpatient Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
UINTAH BASIN MEDICAL CENTER INC
Authorized official
JAMES MARSHALL (CEO)
(435) 722-6162
Entity
Organization
Contact information
Practice address
250 W 300 N, (75-2), ROOSEVELT, UT 84066-2336
(435) 722-6123
Mailing address
250 W 300 N, (75-2), ROOSEVELT, UT 84066-2336
(435) 722-6123
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0002X
Clinic Pharmacy
4788706-1703
UT
3336C0004X
Compounding Pharmacy
4788706-1703
UT
3336L0003X
Long Term Care Pharmacy
4788706-1703
UT
Other
Enumeration date
11/21/2006
Last updated
04/16/2021
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