Provider Demographics
NPI:1699427989
Name:SPECTRUM SOLUTIONS RX, LLC
Entity type:Organization
Organization Name:SPECTRUM SOLUTIONS RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF PHARMACY OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:888-500-4711
Mailing Address - Street 1:12248 S LONE PEAK PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-6418
Mailing Address - Country:US
Mailing Address - Phone:888-500-4711
Mailing Address - Fax:
Practice Address - Street 1:12248 S LONE PEAK PKWY STE 106
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-6418
Practice Address - Country:US
Practice Address - Phone:888-500-4711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty