Panguitch Drug Corp
Organization Active NPI Community/Retail Pharmacy · Panguitch, UT
NPI 1376524280 · NPPES record last updated Feb 24, 2011
Key facts
- NPI
- 1376524280
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 3417951703 (UT)
- Legal business name
- PANGUITCH DRUG CORP
- Practice address
- 95 E Center
Panguitch, UT 84759-0068 - Phone
- (435) 676-2212
- Fax
- (435) 676-8850
- NPI assigned
- Nov 8, 2005
- Organization subpart
- No
Authorized official
- Name
- Steve Marshall, RPH
- Title
- Owner
- Phone
- (435) 676-2212
Practitioners 3
-
Jeremiah Daniel Halstead, PHARMD
-
Samuel Ian Marshall, PHARMD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 3417951703 | UT | Yes |
Addresses
Primary practice location
95 E Center
Panguitch, UT 84759-0068
Mailing address
PO Box 68
Panguitch, UT 84759-0068
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870287657001 | Medicaid | UT | |
| 4601894 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- PANGUITCH DRUG CO
Other providers in Panguitch, UT
- Lynn Anne Maguire
- Lynda Marcks
- Samuel Ian Marshall
- Timothy James Marshall
- Todd Stanley Mooney
- Bryant Pearson
- Melinda Lee Peterson
- Brooke Walter Pieper
- Prevent Inc.
- Carole A Ray
All providers in Panguitch, UT · Community/Retail Pharmacy in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.