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General NPI Number Information
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NPI Number | 1013217736
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Entity Type | Organization
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Legal Business Name | ACUPHARM LLC
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 990 W ATHERTON DR # 200
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City | SALT LAKE CITY
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State | UT
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Zip | 84123-3465
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Country | US
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Telephone | 801-456-4505
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Fax | 801-456-4508
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Provider Business Mailing Address
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Address Line | 990 W ATHERTON DR # 200
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City | SALT LAKE CITY
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State | UT
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Zip | 84123-3465
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Country | US
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Telephone | 801-456-4505
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Fax | 801-456-4508
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Authorized Official
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Title or Position | PHARMACIST
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Name | KEVIN DEMASS
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Credential | BSPHARM
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Telephone | 801-456-4505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 107642931704
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License Number State | UT
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