Hi Mountain Drug
Organization Active NPI Pharmacy · Kamas, UT
NPI 1497890099 · NPPES record last updated Jun 18, 2008
Key facts
- NPI
- 1497890099
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 0285417220 (UT)
- Legal business name
- HI MOUNTAIN DRUG
- Practice address
- 40 North Main
Kamas, UT 84036 - Phone
- (435) 783-4466
- Fax
- (435) 783-4567
- NPI assigned
- Feb 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Craig C Van Tassell, RPH
- Title
- Owner Pharmacist
- Phone
- (435) 783-4466
Practitioners 1
-
Craig C Van Tassell, R.PH.
National Provider Directory
Locations
40 N Main St
Kamas, UT 84036
Phone (435) 783-4466
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 0285417220 | UT | Yes |
Addresses
Primary practice location
40 North Main
Kamas, UT 84036
Mailing address
PO Box 67
Kamas, UT 84036
Phone (435) 783-4466
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870277118002 | Medicaid | UT |
Other providers in Kamas, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2008. 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.