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Organization

PRIME THERAPEUTICS PHARMACY LLC

Active
Other names
Magellan Rx Pharmacy, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREW GLOVER (VP PHARMACY OPERATIONS)
(612) 777-4940
Entity
Organization

Contact information

Practice address
2256 S 3600 W STE A, WEST VALLEY CITY, UT 84119-1124
(855) 271-4810
(888) 656-7762
Mailing address
2256 S 3600 W STE A, SALT LAKE CITY, UT 84119-1124
(855) 271-4810

Taxonomy

Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
9771246-1703
UT

Other

Enumeration date
04/27/2016
Last updated
09/16/2024
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