NPI 1346282951 · live from the CMS NPI Registry
Canyon Pharmaceutical, LLC
Pharmacy, Community/Retail Pharmacy in Provo, UT. National Provider Identifier 1346282951, active.
NPI record
| NPI | 1346282951 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 3179 N Canyon Rd, Provo, UT 84604 |
| Practice phone | 801-377-2002 |
| Enumerated | June 11, 2006 |
| Last updated | August 15, 2022 |
| Authorized official | Ryan Johansen, Owner |
| Other names | Rock Canyon Pharmacy |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacist | 183500000X | 50843661703 (UT) |
| Pharmacy, Compounding Pharmacy | 3336C0004X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.