Provider Demographics
NPI:1609506047
Name:SERVICE DRUG COMPANY INC
Entity Type:Organization
Organization Name:SERVICE DRUG COMPANY INC
Other - Org Name:SERVICE DRUG CO - LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SERVICE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRUG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-864-2545
Mailing Address - Street 1:215 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:UT
Mailing Address - Zip Code:84624-9257
Mailing Address - Country:US
Mailing Address - Phone:435-864-2545
Mailing Address - Fax:435-864-4264
Practice Address - Street 1:215 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:UT
Practice Address - Zip Code:84624-9257
Practice Address - Country:US
Practice Address - Phone:435-864-2545
Practice Address - Fax:435-864-4264
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERVICE DRUG COMPANY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-16
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory