Healthcare Provider Details

I. General information

NPI: 1679823876
Provider Name (Legal Business Name): H2RX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 N MAIN STREET #B
BEAVER UT
84713
US

IV. Provider business mailing address

PO BOX 1508
BEAVER UT
84713-1508
US

V. Phone/Fax

Practice location:
  • Phone: 435-438-5555
  • Fax: 435-438-0707
Mailing address:
  • Phone: 435-438-5555
  • Fax: 435-438-0707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number83576481703
License Number StateUT

VIII. Authorized Official

Name: B. SCOTT ROBINSON
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 435-438-5555