Provider Demographics
NPI:1083343628
Name:GMT PHARMACY PC
Entity Type:Organization
Organization Name:GMT PHARMACY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHARGE PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:OAXACA
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:801-604-8736
Mailing Address - Street 1:1890 S 3850 W STE 220A
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84104-4909
Mailing Address - Country:US
Mailing Address - Phone:801-604-8736
Mailing Address - Fax:
Practice Address - Street 1:1890 S 3850 W STE 220A
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84104-4909
Practice Address - Country:US
Practice Address - Phone:801-604-8736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835X0200XPharmacy Service ProvidersPharmacistOncologyGroup - Single Specialty