Organization
AXIOM SPECIALTY RX
Active
Other names
Axiom Specialty RX
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER NIXON (PHARMACIST)
(801) 727-8106
Entity
Organization
Contact information
Practice address
912 BAXTER DR STE 130, SOUTH JORDAN, UT 84095-5876
(801) 727-8106
(801) 495-5923
Mailing address
912 BAXTER DR STE 130, SOUTH JORDAN, UT 84095-5876
(801) 727-8106
(801) 495-5923
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
77895321704
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4612203
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/25/2012
Last updated
04/25/2012
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