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General NPI Number Information
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NPI Number | 1376920629
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Entity Type | Organization
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Legal Business Name | UTAH VALLEY PHARMACY
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 214 E UNIVERSITY PKWY
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City | OREM
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State | UT
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Zip | 84058-7601
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Country | US
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Telephone | 801-224-3932
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Fax | 801-224-3724
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Provider Business Mailing Address
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Address Line | 214 E UNIVERSITY PKWY
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City | OREM
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State | UT
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Zip | 84058-7601
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Country | US
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Telephone | 801-224-3932
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Fax | 801-224-3724
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Authorized Official
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Title or Position | PHARMACIST-IN-CHARGE
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Name | DAVID GLENN
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Credential |
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Telephone | 801-372-9600
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 93789571703
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License Number State | UT
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