Provider Demographics
NPI:1174191860
Name:ENOCH COMMUNITY PHARMACY
Entity Type:Organization
Organization Name:ENOCH COMMUNITY PHARMACY
Other - Org Name:ENOCH DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:BARROWS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:801-791-0262
Mailing Address - Street 1:476 E MIDVALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ENOCH
Mailing Address - State:UT
Mailing Address - Zip Code:84721-7603
Mailing Address - Country:US
Mailing Address - Phone:435-708-0400
Mailing Address - Fax:833-308-3128
Practice Address - Street 1:476 E MIDVALLEY RD
Practice Address - Street 2:
Practice Address - City:ENOCH
Practice Address - State:UT
Practice Address - Zip Code:84721-7603
Practice Address - Country:US
Practice Address - Phone:801-791-0262
Practice Address - Fax:435-263-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No333600000XSuppliersPharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy