NPI 1366586430

Icotadai INC

Organisation Managed Care Organization Pharmacy Riverton, UT

Practice location

Address: 2332 W 12600 S STE C, Riverton, UT 84065-7161
Phone: (801) 253-6778
Fax: (801) 253-6779

Authorised official

Name: Neal Catalano
Title: President
Phone: (801) 253-6778

Registered specialties

Managed Care Organization Pharmacy Primary

Suppliers Taxonomy 3336M0003X Licence 64211071704 (UT)

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Registry record

NPI: 1366586430
Entity type: Organization
NPI issued: 20 Feb 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.