Organization
OGDEN CLINIC SPECIALTY SERVICES
Active
Parent organization
OGDEN CLINIC UROLOGY PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
OGDEN CLINIC UROLOGY PHARMACY
Authorized official
MARCHELLE JONES (CREDENTIALING SUPERVISOR)
(801) 475-3481
Entity
Organization
Contact information
Practice address
4700 HARRISON BLVD, OGDEN, UT 84403-4303
(801) 475-3160
Mailing address
PO BOX 5546, DENVER, CO 80217-5546
(801) 475-3500
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114203668
—
UT
Enumeration date
02/09/2021
Last updated
02/16/2021
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