NPIMap

Organization Active NPI

Pharmboy Ventures Unlimited Inc

Doing business as Brent's Pharmacy

  • Community/Retail Pharmacy
  • St George, UT
National Provider Identifier
1184134819
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
10527986-1703 Issued in UT
Legal business name
PHARMBOY VENTURES UNLIMITED INC
Doing business as
Brent's Pharmacy
Practice address
2376 E Red Cliffs Drive
Suite 377
St. George, UT 84790
Phone
(435) 255-7160
Fax
(435) 255-7202
NPI assigned
Oct 9, 2017
Last updated
Mar 29, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
PHARMBOY VENTURES UNLIMITED INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Caroline S McFadden
Title
Pharmacist
Phone
(435) 255-7160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 10527986-1703 UT Primary

Addresses

Primary practice location

2376 E Red Cliffs Drive
Suite 377
St. George, UT 84790

Mailing address

2376 Red Cliffs Dr Ste 377
St George, UT 84790-8367

Other names 1

  • Brent's Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161011000177 UT Part B Supplier - Mass Immunization (Roster Biller Only) 1658530530 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: St George, UT

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pharmboy Ventures Unlimited Inc3 organizations share this tax ID, including this one
Part of
Pharmboy Ventures Unlimited Inc

Other organizations with this tax ID 2

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

Locations

2376 Red Cliffs Dr
Ste 377
St George, UT 84790
Phone (435) 255-7160

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1184134819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2376 RED CLIFFS DR STE 377",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 E RED CLIFFS DRIVE",
            "address_2": "SUITE 377",
            "city": "ST. GEORGE",
            "state": "UT",
            "postal_code": "84790",
            "telephone_number": "435-255-7160",
            "fax_number": "435-255-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMBOY VENTURES UNLIMITED INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHARMBOY VENTURES UNLIMITED INC",
        "enumeration_date": "2017-10-09",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "MCFADDEN",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "435-255-7160"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "10527986-1703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brent's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brent's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.