Organization
UNIVERSITY OF UTAH
Active
Other names
MIDVALLEY SPECIALTY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEE K HOWELL CPHT (PHARMACY BUSINESS OPERATIONS MANAGE)
(801) 587-6334
Entity
Organization
Contact information
Practice address
6056 S FASHION SQUARE DR STE 1000, SUITE 1000, MURRAY, UT 84107-5410
(801) 213-8650
(801) 262-2802
Mailing address
PO BOX 841208, LOS ANGELES, CA 90084-1208
(801) 587-6334
(801) 587-2996
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
97367431703
UT
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159504
PK
—
01
—
4613522
NCPDP
—
Enumeration date
03/28/2016
Last updated
03/16/2021
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