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General NPI Number Information
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NPI Number | 1982039590
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Entity Type | Organization
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Legal Business Name | G THRIFT CORPORATION INC
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 520 S MAIN
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City | GUNNISON
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State | UT
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Zip | 84634
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Country | US
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Telephone | 435-528-7555
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Fax | 435-528-7553
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Provider Business Mailing Address
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Address Line | PO BOX 395
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City | GUNNISON
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State | UT
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Zip | 84634-0395
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Country | US
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Telephone | 435-528-3698
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Fax | 435-528-7553
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | SHAWN SORENSEN
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Credential |
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Telephone | 435-528-7555
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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 | 8733265-1703
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License Number State | UT
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