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General NPI Number Information
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NPI Number | 1497170401
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Entity Type | Organization
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Legal Business Name | HOBBLE CREEK FAMILY PHARMACIES LLC
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 286 W CENTER ST
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City | PROVO
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State | UT
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Zip | 84601-4419
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Country | US
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Telephone | 801-373-7288
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Fax | 801-373-0673
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Provider Business Mailing Address
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Address Line | 286 W CENTER ST
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City | PROVO
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State | UT
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Zip | 84601-4419
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Country | US
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Telephone | 801-373-7288
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Fax | 801-373-0673
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Authorized Official
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Title or Position | PHARMACIST
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Name | KENT TAYLOR
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Credential |
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Telephone | 801-373-7288
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 8890134-1703
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License Number State | UT
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