Fresh Market Pharmacy #2312

LBN: Associated Fresh Markets Inc
Fresh Market Pharmacy #2312 is an health care organization with primary practice located at 560 W Center St , Provo UT 84601-4276. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Associated Fresh Markets Inc can be contacted via phone (801) 374-1704, or through Hanson, Shawna via phone (801) 978-8309.

Contact Information

Primary practice address
560 W Center St Provo UT 84601-4276
Phone: (801) 374-1704
Fax: (801) 374-0964
Website:
Map and Directions
Authorized official contact:
Name: Hanson, Shawna PHARMD
Phone: (801) 978-8309

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 7442351-1703 Utah
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1427381714
LBN Legal business name Associated Fresh Markets Inc
DBA Doing business as Fresh Market Pharmacy #2312
Authorized official Hanson, Shawna PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Sep 17th, 2009
Last updated Apr 5th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427381714 NPPES
Utah MEDICAID 1427381714
Utah Other 2121823

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