Organization
CLEARFIELD JOB CORPS PHARMACY
Active
Other names
CLEARFIELD JOB CORPS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LORI HENRY RM (WELLNESS ADMINISTRATOR)
(801) 416-4628
Entity
Organization
Contact information
Practice address
20 W 1700 S, CLEARFIELD, UT 84016-6004
(801) 416-4467
(801) 416-4636
Mailing address
PO BOX 160070, CLEARFIELD, UT 84016-0070
(801) 416-4467
(801) 416-4636
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
1268151704
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4601351
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/22/2006
Last updated
08/07/2009
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