Healthcare Provider Details

I. General information

NPI: 1295966414
Provider Name (Legal Business Name): APOTHECARY POINTE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 W 5600 S
ROY UT
84067-9103
US

IV. Provider business mailing address

3443 W 5600 S
ROY UT
84067-9103
US

V. Phone/Fax

Practice location:
  • Phone: 801-825-6400
  • Fax: 801-825-6449
Mailing address:
  • Phone: 801-825-6400
  • Fax: 801-825-6449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number90108591703
License Number StateUT

VIII. Authorized Official

Name: CODY HYMAS
Title or Position: PHARMACIST IN-CHARGE
Credential: RPH
Phone: 801-825-6400