Healthcare Provider Details

I. General information

NPI: 1922401256
Provider Name (Legal Business Name): SP CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 E 1400 S STE 4
ST. GEORGE UT
84790
US

IV. Provider business mailing address

291 E 1400 S STE 4
ST. GEORGE UT
84790
US

V. Phone/Fax

Practice location:
  • Phone: 435-703-2273
  • Fax: 435-703-2274
Mailing address:
  • Phone: 435-703-2273
  • Fax: 435-703-2274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number94262441704
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KENNETH JONES
Title or Position: MEMBER
Credential:
Phone: 435-817-5559