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Organization

RED BEAKER INC

Active
Other names
EDGEMONT PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MIKE CHAMBERLAIN RPH (OWNER / RPH)
(801) 226-7994
Entity
Organization

Contact information

Practice address
3661 N CANYON RD, PROVO, UT 84604-4536
(801) 226-7994
(801) 226-2166
Mailing address
3661 N CANYON RD, PROVO, UT 84604-4536
(801) 226-7994
(801) 226-2166

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
45500841703
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2107781
PK
05
870349306009
UT
Enumeration date
07/04/2006
Last updated
07/19/2018
Update your record

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