NPIMap

Organization Active NPI

Skull Valley Health Clinic

Doing business as Skull Valley Pharmacy

  • Pharmacy
  • Tooele, UT
National Provider Identifier
1528525508
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SKULL VALLEY HEALTH CLINIC
Doing business as
Skull Valley Pharmacy
Practice address
1929 N Aaron Dr Ste I
Tooele, UT 84074-8112
Phone
(435) 850-1825
Fax
(844) 847-4640
NPI assigned
Feb 26, 2019
Last updated
Feb 26, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SKULL VALLEY HEALTH CLINIC INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Authorized official

Name
Cima Ghaffarian, PHARMD
Title
Director
Phone
(435) 850-1825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

1929 N Aaron Dr Ste I
Tooele, UT 84074-8112

Mailing address

1929 N Aaron Dr Ste I
Tooele, UT 84074-8112
Phone (435) 850-1825

Other names 1

  • Skull Valley Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Warrior Spirit Recovery Center3 organizations share this tax ID, including this one
Part of
Warrior Spirit Recovery Center

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551139200000",
    "number": "1528525508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 N AARON DR STE I",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748112",
            "telephone_number": "435-850-1825",
            "fax_number": "844-847-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 N AARON DR STE I",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748112",
            "telephone_number": "435-850-1825",
            "fax_number": "844-847-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKULL VALLEY HEALTH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SKULL VALLEY HEALTH CLINIC INC",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A",
        "authorized_official_last_name": "GHAFFARIAN",
        "authorized_official_first_name": "CIMA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "435-850-1825",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skull Valley Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tooele, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.