Organization
BRIGHAM YOUNG UNIVERSITY
Active
Other names
BRIGHAM YOUNG UNIVERSITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES C AVERETT RPH (DIRECTOR OF PHARMACY)
(801) 422-9701
Entity
Organization
Contact information
Practice address
1750 N WYMOUNT TERRACE DR, PROVO, UT 84604-8600
(801) 422-5171
(801) 422-0812
Mailing address
1750 N WYMOUNT TERRACE DR, PROVO, UT 84604-8600
(801) 422-5171
(801) 422-0812
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
359430-1703
UT
3336C0002X
Clinic Pharmacy
3594301703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4601971
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/09/2007
Last updated
08/19/2015
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