Healthcare Provider Details

I. General information

NPI: 1356215008
Provider Name (Legal Business Name): BADGER MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 NORTH MAIN STREET
VINEYARD UT
84059
US

IV. Provider business mailing address

505 E 1400 N STE 110
LOGAN UT
84341-2459
US

V. Phone/Fax

Practice location:
  • Phone: 385-472-2385
  • Fax: 385-472-2385
Mailing address:
  • Phone: 435-774-4150
  • Fax: 435-774-4166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL GRIMES
Title or Position: DIRECTOR OF PHARMACY
Credential: RPH
Phone: 435-774-4150