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General NPI Number Information
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NPI Number | 1699427989
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Entity Type | Organization
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Legal Business Name | SPECTRUM SOLUTIONS RX, LLC
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 12248 S LONE PEAK PKWY STE 106
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City | DRAPER
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State | UT
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Zip | 84020-6418
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Country | US
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Telephone | 888-500-4711
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Fax |
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Provider Business Mailing Address
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Address Line | 12248 S LONE PEAK PKWY STE 106
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City | DRAPER
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State | UT
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Zip | 84020-6418
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Country | US
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Telephone | 888-500-4711
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Fax |
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Authorized Official
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Title or Position | VP OF PHARMACY OPERATIONS
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Name | DR. TYLER GUNDERSON
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Credential | PHARMD
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Telephone | 888-500-4711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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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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