A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Non-Pharmacy Dispensing Site |
332900000X | 87 | All Other Suppliers |
| NPI Number | 1316330749 |
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| LBN Legal business name | CENTRAL UTAH CLINIC, P.C. | ||||
| Authorized official | JED HARSTON - (DIRECTOR OF MANAGED CARE) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 03/10/2015 | ||||
| Last updated | 06/16/2018 - About 8 years ago | ||||
| Identifiers |
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