Healthcare Provider Details

I. General information

NPI: 1992980304
Provider Name (Legal Business Name): H N A OF UTAH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 01/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 E 300 N
MORGAN UT
84050
US

IV. Provider business mailing address

PO BOX 1109
MORGAN UT
84050-1109
US

V. Phone/Fax

Practice location:
  • Phone: 801-829-6271
  • Fax: 801-829-6278
Mailing address:
  • Phone: 801-829-6271
  • Fax: 801-829-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number6782321-1703
License Number StateUT

VIII. Authorized Official

Name: NATHAN ADAMS
Title or Position: PHARMACY MANAGER
Credential: PHARM D
Phone: 801-829-6271