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General NPI Number Information
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NPI Number | 1639131907
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Entity Type | Organization
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Legal Business Name | CARBON MEDICAL SERVICE ASSOCIATION INCORPORATED
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 331 E HIGHWAY 123
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City | SUNNYSIDE
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State | UT
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Zip | 84539-7725
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Country | US
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Telephone | 435-888-4411
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Fax | 435-888-2270
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Provider Business Mailing Address
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Address Line | PO BOX 930
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City | EAST CARBON
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State | UT
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Zip | 84520-0930
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Country | US
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Telephone | 435-888-4411
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Fax | 435-888-2270
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Authorized Official
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Title or Position | CREDENTIALING
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Name | VANESSA ANDERSON
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Credential |
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Telephone | 435-888-4411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | UT
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