Organization
HEALTHWISE PHARMACY INC
Active
Other names
HEALTHWISE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN HICKMAN (PHARMACIST IN CHARGE)
(801) 489-7300
Entity
Organization
Contact information
Practice address
724 S 1600 W, MAPLETON, UT 84664-4347
(801) 489-7300
(801) 489-4949
Mailing address
724 S 1600 W, MAPLETON, UT 84664-4347
(801) 489-7300
(801) 489-4949
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
8359105-1704
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100773
PK
—
Enumeration date
04/19/2007
Last updated
10/05/2015
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