Provider Demographics
NPI:1548795461
Name:CD PHARMACY LLC
Entity Type:Organization
Organization Name:CD PHARMACY LLC
Other - Org Name:RED ROCK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:EDDIE
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-712-7522
Mailing Address - Street 1:450 S 900 E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2981
Mailing Address - Country:US
Mailing Address - Phone:801-712-2088
Mailing Address - Fax:
Practice Address - Street 1:863 W 450 S
Practice Address - Street 2:SUITE 101
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663
Practice Address - Country:US
Practice Address - Phone:801-477-9444
Practice Address - Fax:801-477-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy