Rock Canyon Pharmacy

LBN: Canyon Pharmaceutical, Llc
Rock Canyon Pharmacy is an health care organization with primary practice located at 3179 N Canyon Rd , Provo UT 84604-3916. The organization recently has 3 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Canyon Pharmaceutical, Llc can be contacted via phone (801) 377-2002, or through Johansen, Ryan via phone (801) 440-2995.

Contact Information

Primary practice address
3179 N Canyon Rd Provo UT 84604-3916
Phone: (801) 377-2002
Fax: (801) 377-2007
Website:
Map and Directions
Authorized official contact:
Name: Johansen, Ryan
Phone: (801) 440-2995

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 50843661703 Utah
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1346282951
LBN Legal business name Canyon Pharmaceutical, Llc
DBA Doing business as Rock Canyon Pharmacy
Authorized official Johansen, Ryan
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2006
Last updated Aug 15th, 2022 - about 2 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 1346282951 NPPES
Utah MEDICAID 710871500008

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