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General NPI Number Information
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NPI Number | 1245536051
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Entity Type | Organization
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Legal Business Name | SBB PHARMACEUTICAL LLC
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 213 E MAIN ST
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City | GRANTSVILLE
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State | UT
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Zip | 84029-9029
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Country | US
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Telephone | 435-884-9990
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Fax | 435-884-6997
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Provider Business Mailing Address
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Address Line | 4776 AUTUMN CV
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City | ERDA
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State | UT
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Zip | 84074-5548
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Country | US
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Telephone | 435-884-9990
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Fax | 435-884-6997
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Authorized Official
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Title or Position | OWNER
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Name | SHELDON BIRCH
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Credential |
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Telephone | 435-882-7775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 7907135-1703
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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