Sundance Pharmacy LLC

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

56416441704 Issued in UT

Legal business name

SUNDANCE PHARMACY LLC

Practice address

538 N 1300 E
Saint George, UT 84770-3222

Phone

(435) 673-9204

Fax

(435) 628-2865

NPI assigned

Jan 25, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Clem McEwenNPI 1194870204

Title

Pharmacist Manager

Phone

(435) 673-9204

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clem Fenn McEwen

  • Pharmacist
  • St George, UT
  • NPI 1194870204
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033264130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 N 1300 E",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847703222",
            "telephone_number": "435-673-9204",
            "fax_number": "435-628-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 N 1300 E",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847703222",
            "telephone_number": "435-673-9204",
            "fax_number": "435-628-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCEWEN",
        "authorized_official_first_name": "CLEM",
        "authorized_official_title_or_position": "PHARMACIST MANAGER",
        "authorized_official_telephone_number": "435-673-9204",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "UT",
            "license": "56416441704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Rehabilitation LLC
• Charles Sumpter, PA-C
• Stacy Lynn Sumpter, DNP-C
• Sun Tree Home Health LLC (Sun Tree Home Health)
• Sun Tree Hospice LLC (Mission Hospice Services of St. George)
• Sunhawk Adolescent Recovery Center
• Sunset Dental - Accelerate, LLC
• Sunset Dental Group, LLC
• Sunset Physical Therapy, L.L.C.
• Sunset Smiles Dentistry

• Mail Order Pharmacy in St George, UT
• Providers in St George, UT by specialty
• Mail Order Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.