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General NPI Number Information
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NPI Number | 1497088108
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Entity Type | Organization
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Legal Business Name | ASSOCIATED FRESH MARKETS INC
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Dates
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Enumeration Date | 09/13/2009
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 3945 WASHINGTON BLVD
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City | OGDEN
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State | UT
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Zip | 84403-1825
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Country | US
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Telephone | 801-393-8680
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Fax | 801-334-6563
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Provider Business Mailing Address
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Address Line | PO BOX 26908
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City | SALT LAKE CITY
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State | UT
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Zip | 84126-0908
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Country | US
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Telephone | 801-978-8225
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Fax | 801-978-8634
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Authorized Official
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Title or Position | DIRECTOR, PHARMACY OPERATIONS
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Name | SHAWNA HANSON
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Credential | PHARMD
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Telephone | 801-978-8309
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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 | 7442336-1703
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License Number State | UT
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