Confederated Tribes of the Goshute Reservation
NPI #1790370955 in West Valley, Utah
Provider Information
- NPI Number
- 1790370955
- Entity Type
- Organization
- Organization Name
- Confederated Tribes of the Goshute Reservation
- Primary Specialty
- Pharmacy - Clinic Pharmacy
- Enumeration Date
- Mar 9, 2021
- Last Updated
- Mar 9, 2021
Practice Location
- Address
- 3448 S 3200 W
- City
- West Valley
- State
- Utah
- ZIP Code
- 84119-2628
- Phone
- (801) 359-2256
Authorized Official
- Name
- CRYSTAL CONTRERAS
- Title
- BILLING MANAGER
- Phone
- (801) 359-2256
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Clinic Pharmacy — Clinic Pharmacy |
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