Provider Demographics
NPI:1174819734
Name:U OF U HOSPITAL PHARMACY
Entity Type:Organization
Organization Name:U OF U HOSPITAL PHARMACY
Other - Org Name:INPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY SERVICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOWALCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-585-6704
Mailing Address - Street 1:50 N MEDICAL DR
Mailing Address - Street 2:PHARMACY A050
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0001
Mailing Address - Country:US
Mailing Address - Phone:801-581-2147
Mailing Address - Fax:
Practice Address - Street 1:50 N MEDICAL DR
Practice Address - Street 2:PHARMACY A050
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-581-2147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT120245-1704282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital