Organization
FAMILY PLAZA PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE MICHAEL JENSEN PHARMD (PRESIDENT)
(801) 569-0175
Entity
Organization
Contact information
Practice address
3570 W 9000 S STE 150, WEST JORDAN, UT 84088-8872
(801) 569-0175
(801) 569-8941
Mailing address
3570 W 9000 S STE 150, WEST JORDAN, UT 84088-8872
(801) 569-0175
(801) 569-8941
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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