Spanish Valley Clinic Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SPANISH VALLEY CLINIC PHARMACY

Practice address

5555 Old Airport Rd.
Spanish Valley, UT 84532

Phone

(435) 587-1181

NPI assigned

Jun 25, 2021

Last updated

Nov 16, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

SAN JUAN HEALTH SERVICE DISTRICTAs reported in NPPES

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

Authorized official

Name

Brian Joseph Bothwell, PHARM D

Title

Director of Pharmacy

Phone

(435) 587-2116

Specialties & licenses 2

Addresses

Tax ID family

Monument Valley Health3 organizations share this tax ID, including this one

Part of

Monument Valley Health

Other organizations with this tax ID 2

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

• San Juan County Hospital

  dba Spanish Valley Clinic

  • Rural Health Clinic/Center
  • Spanish Valley, UT
  • NPI 1588978738
  NPD tax ID
• San Juan County Hospital

  dba San Juan Healthcare Services

  • Medicare Defined Swing Bed Hospital Unit
  • Monticello, UT
  • NPI 1831351816
  NPD tax ID

Locations

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1114597853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W 100 N",
            "address_2": "PO BOX 308",
            "city": "MONTICELLO",
            "state": "UT",
            "postal_code": "84535",
            "telephone_number": "435-587-2116",
            "fax_number": "435-587-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 OLD AIRPORT RD.",
            "city": "SPANISH VALLEY",
            "state": "UT",
            "postal_code": "84532",
            "telephone_number": "435-587-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPANISH VALLEY CLINIC PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN JUAN HEALTH SERVICE DISTRICT",
        "enumeration_date": "2021-06-25",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "BOTHWELL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "435-587-2116",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Juan County Hospital (Spanish Valley Clinic)

• Community/Retail Pharmacy in Spanish Valley, UT
• Providers in Spanish Valley, UT by specialty
• Community/Retail Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.