Healthcare Provider Details

I. General information

NPI: 1609976257
Provider Name (Legal Business Name): CFK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 E 500 S
BOUNTIFUL UT
84010-6227
US

IV. Provider business mailing address

47 E 500 S
BOUNTIFUL UT
84010-6227
US

V. Phone/Fax

Practice location:
  • Phone: 801-295-3463
  • Fax: 801-298-8223
Mailing address:
  • Phone: 801-295-3463
  • Fax: 801-298-8223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number130359-1703
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number9255274-1703
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier4606375
Identifier TypeOTHER
Identifier StateUT
Identifier IssuerNCPDP
# 2
Identifier870295458002
Identifier TypeMEDICAID
Identifier StateUT
Identifier Issuer

VIII. Authorized Official

Name: CHANDLER M. FRAME
Title or Position: OWNER
Credential:
Phone: 818-726-8810