Organization Name: | MEDQUEST PHARMACY |
NPI Number: | 1356601108 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KYLE ANDERSON (COMPLIANCE OFFICER) |
Mailing Address: | 669 W 900 N North Salt Lake |
State: | UT US |
Postal Code: | 840542602 |
Phone Number: | 8012941400 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2012 |
NPI Last Update Date: | 05/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3336C0004X |
License Number: | 5872299-1703 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | Compounding Pharmacy |
Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |