Organization
GRANGER CLINIC PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA YOUNG (OWNER)
(801) 965-3639
Entity
Organization
Contact information
Practice address
3725 W 4100 S, WEST VALLEY CITY, UT 84120-5530
(801) 965-3639
(801) 965-9641
Mailing address
3725 W 4100 S, WEST VALLEY CITY, UT 84120-5530
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
61710311703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4610502
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
08/22/2020
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