Healthcare Provider Details

I. General information

NPI: 1538516588
Provider Name (Legal Business Name): CEDAR DRUG AND GIFT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S MAIN ST STE 7
CEDAR CITY UT
84720-3653
US

IV. Provider business mailing address

755 S MAIN ST STE 7
CEDAR CITY UT
84720-3653
US

V. Phone/Fax

Practice location:
  • Phone: 435-586-7578
  • Fax: 435-267-1500
Mailing address:
  • Phone: 435-586-7578
  • Fax: 435-267-1500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number9795159-1703
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RORY SMITH
Title or Position: PRESIDENT
Credential:
Phone: 435-586-7578