Organization
MOUNTAIN WEST MEDICINE, INC.
Active
Other names
MountainWest Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE SUZANNE LINDBERG PHARM D. (OWNER/PHARMACIST)
(801) 295-6979
Entity
Organization
Contact information
Practice address
1551 S RENAISSANCE TOWNE DR, SUITE 104, BOUNTIFUL, UT 84010
(801) 295-6979
(801) 295-6989
Mailing address
1551 S RENAISSANCE TOWNE DR, SUITE 104, BOUNTIFUL, UT 84010
(801) 295-6979
(801) 295-6989
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5731786-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201309057001
—
UT
Enumeration date
12/14/2006
Last updated
10/15/2020
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