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Confederated Tribes Of The Goshute Reservation
Clinic Pharmacy in Salt Lake City, Utah
NPI 1003251638

Confederated Tribes Of The Goshute Reservation is a Clinic Pharmacy based in Salt Lake City, UT and is specialized in Clinic Pharmacy. Confederated Tribes Of The Goshute Reservation practices in Salt Lake City, UT. The NPI Number for Confederated Tribes Of The Goshute Reservation is 1003251638 and holds a License No. 8547079-1704 (Utah).

The current practice location address for Confederated Tribes Of The Goshute Reservation is 660 S 200 E Ste 250, Salt Lake City, UT and can be reached out via phone at 801-359-2256.

Location: 660 S 200 E Ste 250, Salt Lake City, UT, 84111-3835
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1003251638
Provider Name
Confederated Tribes Of The Goshute Reservation
Credential
Provider Entity Type
Organization
Address
660 S 200 E Ste 250, Salt Lake City, UT, 84111-3835
Phone Number
801-359-2256
Fax Number
Provider Enumeration Date
05/09/2013
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2140406 01 PK
institution
Provider Business Practice Location Address Details
Address
660 S 200 E Ste 250
City
Salt Lake City
State
Utah
Zip
84111-3846
Phone Number
801-359-2256
Fax Number
person
Provider Business Mailing Address Details
Address
660 S 200 E Ste 250
City
Salt Lake City
State
Utah
Zip
84111-3846
Phone Number
801-359-2256
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Speciality
-
Taxonomy
332800000X
License No.
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Definition
An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
Clinic Pharmacy
Taxonomy
3336C0002X
License No.
8547079-1704 (Utah)
Definition
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
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