Provider Demographics
NPI:1891188207
Name:ROY PHARMACY GROUP
Entity Type:Organization
Organization Name:ROY PHARMACY GROUP
Other - Org Name:ROY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-732-0202
Mailing Address - Street 1:3460 W 4800 S
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-9430
Mailing Address - Country:US
Mailing Address - Phone:801-732-0202
Mailing Address - Fax:
Practice Address - Street 1:3460 W 4800 S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-9430
Practice Address - Country:US
Practice Address - Phone:801-732-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT11217788-1703OtherSTATE LICENSE