Organization
T & R PHARMACEUTICAL LLC
Active
Other names
JOLLEYS SANDY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TROY JOHANSEN (MANAGER)
(801) 571-0201
Entity
Organization
Contact information
Practice address
9829 S 1300 E, SUITE 100, SANDY, UT 84094-4000
(801) 571-0201
(801) 571-6050
Mailing address
9829 S 1300 E, SUITE 100, SANDY, UT 84094-4000
(801) 571-0201
(801) 571-6050
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
62985071703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108210
PK
—
Enumeration date
11/03/2006
Last updated
11/08/2021
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