Healthcare Provider Details

I. General information

NPI: 1407920259
Provider Name (Legal Business Name): SHARED PHARMACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4843 S MURRAY BLVD
MURRAY UT
84123-2679
US

IV. Provider business mailing address

4843 S MURRAY BLVD
MURRAY UT
84123-2679
US

V. Phone/Fax

Practice location:
  • Phone: 801-262-6980
  • Fax: 801-263-6503
Mailing address:
  • Phone: 801-262-6980
  • Fax: 801-263-1587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number8141207-1704
License Number StateUT

VIII. Authorized Official

Name: MR. MUNIR MERCHANT
Title or Position: DIRECTOR OF PHARMACY
Credential: RPH
Phone: 801-262-6980