Organization
APOTHECARY SHOP OF SANDY INC
Active
Parent organization
APOTHECARY HOLDINGS INC
Other names
SOUTHWOOD APOTHECARY SHOP
Organization subpart
Yes
Provider details
NPI number
Legal business name
APOTHECARY HOLDINGS INC
Authorized official
NATHAN DOWNHOUR PHRMD (VP OF OPERATIONS)
(623) 434-3654
Entity
Organization
Contact information
Practice address
880 E 9400 S, STE 118, SANDY, UT 84094-3667
(801) 571-0340
(801) 576-8938
Mailing address
1606 W WHISPERING WIND DR, PHOENIX, AZ 85085-0678
(623) 434-3659
(623) 434-3673
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
69707811703
UT
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4603165
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
67629
MEDICARE - MASS IMMUNIZATION ROSTER BILLER
—
05
—
8703064560008
—
UT
Enumeration date
07/06/2006
Last updated
11/06/2009
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