Organization
WEST GORDON PHARMACY INC
Active
Other names
West Gordon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BURNETT (SECRETARY)
(435) 512-2102
Entity
Organization
Contact information
Practice address
3225 W GORDON AVE STE 2, LAYTON, UT 84041-5728
(801) 544-7979
(801) 682-8011
Mailing address
3225 W GORDON AVE STE 2, LAYTON, UT 84041-5728
(801) 544-7979
(801) 682-8011
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9221852-1703
UT
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528464336
—
UT
01
—
2149549
PK
—
Enumeration date
11/06/2014
Last updated
12/03/2019
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