12Th Street Pharmacy

LBN: 12Th St Pharmacy Inc
12Th Street Pharmacy is an health care organization with primary practice located at 698 12Th St , Ogden UT 84404-6200. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. 12Th St Pharmacy Inc can be contacted via phone (801) 621-2154, or through Eggleston, Wallace via phone (801) 621-2154.

Contact Information

Primary practice address
698 12Th St Ogden UT 84404-6200
Phone: (801) 621-2154
Fax: (801) 627-9523
Website:
Map and Directions
Authorized official contact:
Name: Eggleston, Wallace
Phone: (801) 621-2154

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Clinic Pharmacy 3336C0002X
Suppliers / Community/Retail Pharmacy 3336C0003X 362500-1703 Utah

Profile Details

NPI number 1538284716
LBN Legal business name 12Th St Pharmacy Inc
DBA Doing business as 12Th Street Pharmacy
Authorized official Eggleston, Wallace
Entity Organization
Organization subpart 1 No
Enumeration date Mar 20th, 2007
Last updated Sep 23rd, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1538284716 NPPES
Other 2100182 PK

Popular Providers