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General NPI Number Information
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NPI Number | 1811708308
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Entity Type | Organization
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Legal Business Name | CACHE VALLEY PHARMACARE LLC
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 2245 N 400 E STE 105
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City | NORTH LOGAN
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State | UT
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Zip | 84341-1785
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Country | US
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Telephone | 435-757-1212
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Fax | 435-787-1922
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Provider Business Mailing Address
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Address Line | PO BOX 1438
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City | BEAVER
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State | UT
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Zip | 84713-1438
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BYRON SCOTT ROBINSON
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Credential | RPH
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Telephone | 435-421-1685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 |
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License Number State |
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