Healthcare Provider Details

I. General information

NPI: 1285663021
Provider Name (Legal Business Name): PHILRICH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 N 400 E STE 105
NORTH LOGAN UT
84341-1785
US

IV. Provider business mailing address

2245 N 400 E STE 105
NORTH LOGAN UT
84341-1785
US

V. Phone/Fax

Practice location:
  • Phone: 435-787-1212
  • Fax: 435-787-1922
Mailing address:
  • Phone: 435-787-1212
  • Fax: 435-787-1922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5092448-1703
License Number StateUT

VIII. Authorized Official

Name: PHILLIP R COWLEY
Title or Position: OWNER
Credential: RPH
Phone: 435-787-1212