Professional Park

LBN: Professional Park Pharmacy Inc
Professional Park is an health care organization with primary practice located at 736 S 900 E Ste 102 , St George UT 84790-7001. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Professional Park Pharmacy Inc can be contacted via phone (435) 652-1548, or through Anderson, R Brad via phone (435) 652-1548.

Contact Information

Primary practice address
736 S 900 E Ste 102 St George UT 84790-7001
Phone: (435) 652-1548
Fax: (435) 652-3059
Website:
Map and Directions
Authorized official contact:
Name: Anderson, R Brad
Phone: (435) 652-1548

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 3506771703 Utah

Profile Details

NPI number 1891770715
LBN Legal business name Professional Park Pharmacy Inc
DBA Doing business as Professional Park
Authorized official Anderson, R Brad
Entity Organization
Organization subpart 1 No
Enumeration date Dec 13th, 2005
Last updated Nov 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 1891770715 NPPES
Other 2100294 PK

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