NPIMap

Organization Active NPI

Phil Rich Inc

Doing business as LTC of Cache Valley

  • Long Term Care Pharmacy
  • North Logan, UT
National Provider Identifier
1114024957
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
61935351704 Issued in UT
Legal business name
PHIL RICH INC
Doing business as
LTC of Cache Valley
Practice address
2380 N 400 E
E2
North Logan, UT 84341-1749
Phone
(435) 787-1212
Fax
(435) 787-1922
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Phillip Cowley, RPH
Title
Owner
Phone
(435) 787-1212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 61935351704 UT Primary

Addresses

Primary practice location

2380 N 400 E
E2
North Logan, UT 84341-1749

Mailing address

2380 N 400 E
E2
North Logan, UT 84341-1749

Other identifiers 2

IdentifierTypeStateIssuer
4610627OtherOTHER ID NUMBER-COMMERCIAL NUMBER
61935351704MedicaidUT

Other names 1

  • LTC OF CACHE VALLEY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Philrich Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2380 N 400 E
#E2
North Logan, UT 84341
Phone (435) 787-1212

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114024957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 N 400 E",
            "address_2": "E2",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 N 400 E",
            "address_2": "E2",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411749",
            "telephone_number": "435-787-1212",
            "fax_number": "435-787-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHIL RICH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COWLEY",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-787-1212",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "UT",
            "license": "61935351704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4610627",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61935351704",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LTC OF CACHE VALLEY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Logan, UT

Sources for this page

  • 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.