Organization
BLUE EYES OF UTAH LLC
Active
Other names
Mountain Range Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH ALLEN BRESSERS R.PH (SOLE MEMBER)
(920) 685-5041
Entity
Organization
Contact information
Practice address
157 E RIVERSIDE DR, SUITE 3E, ST GEORGE, UT 84790-6886
(435) 359-1805
Mailing address
205 E MAIN ST, OMRO, WI 54963-1417
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
9777440-1704
UT
Other
Enumeration date
05/17/2016
Last updated
08/06/2016
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