NPIMap

Organization Active NPI

Pharmboy Ventures Unlimited Inc

  • Community/Retail Pharmacy
  • Saint George, UT
National Provider Identifier
1750687802
Registry record updated Mar 17, 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
Practice address
1091 N Bluff St
Saint George, UT 84770-4894
Phone
(435) 674-5667
Fax
(435) 628-1774
NPI assigned
Feb 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Caroline S McFadden
Title
Owner
Phone
(435) 674-5667

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 7884853-1703 UT
Community/Retail Pharmacy 3336C0003X 10527986-1703 UT Primary

Addresses

Primary practice location

1091 N Bluff St
Saint George, UT 84770-4894

Mailing address

1091 N Bluff St
Suite 1005
Saint George, UT 84770-4894
Phone (435) 674-5667

Other practice location 1

2376 Red Cliffs Dr
Saint George, UT 84790-8367
Phone (435) 773-2357

Other identifiers 2

IdentifierTypeStateIssuer
1750687802MedicaidUT
2128383OtherPK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120313000288 UT DME Supplier - Pharmacy 1658530530 Practice locations: St George, UT
O20161011000177 UT Part B Supplier - Mass Immunization (Roster Biller Only) 1658530530 1 other NPI on this 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

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1750687802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 N BLUFF ST",
            "address_2": "SUITE 1005",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704894",
            "telephone_number": "435-674-5667",
            "fax_number": "425-628-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 N BLUFF ST",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704894",
            "telephone_number": "435-674-5667",
            "fax_number": "435-628-1774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2376 Red Cliffs Dr",
            "address_purpose": "LOCATION",
            "city": "Saint George",
            "state": "UT",
            "postal_code": "847908367",
            "country_code": "US",
            "telephone_number": "435-773-2357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHARMBOY VENTURES UNLIMITED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MCFADDEN",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-674-5667"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "7884853-1703",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "10527986-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750687802",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2128383",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.