Provider Demographics
NPI:1760232169
Name:NOMI PHARMA, LLC
Entity Type:Organization
Organization Name:NOMI PHARMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR DIRECTOR, PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BRYNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-375-6453
Mailing Address - Street 1:3696 W 2100 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-1202
Mailing Address - Country:US
Mailing Address - Phone:385-375-6555
Mailing Address - Fax:385-375-6563
Practice Address - Street 1:3696 W 2100 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-1202
Practice Address - Country:US
Practice Address - Phone:385-375-6555
Practice Address - Fax:385-375-6563
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOMI HEALTH INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy