Organization
PROFESSIONAL PARK PHARMACY INC
Active
Other names
PROFESSIONAL PARK, PROFESSIONAL PARK PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
R BRAD ANDERSON (PRESIDENT)
(435) 652-1548
Entity
Organization
Contact information
Practice address
736 S 900 E STE 102, ST GEORGE, UT 84790-7001
(435) 652-1548
(435) 652-3059
Mailing address
736 S 900 E STE 102, ST GEORGE, UT 84790-7001
(435) 652-1548
(435) 652-3059
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
3506771703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100294
PK
—
Enumeration date
12/13/2005
Last updated
11/15/2022
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