Healthcare Provider Details

I. General information

NPI: 1326961798
Provider Name (Legal Business Name): BVP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 NORTH HWY 414
MOUNTAIN VIEW WY
82939
US

IV. Provider business mailing address

PO BOX 1699
EVANSTON WY
82931-1699
US

V. Phone/Fax

Practice location:
  • Phone: 307-782-3784
  • Fax:
Mailing address:
  • Phone: 307-782-3784
  • Fax: 307-782-3785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANDREW CANNON
Title or Position: MANAGING MEMBER
Credential: PHARMD
Phone: 801-633-7974