Spence'S Prescription Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1259851703 Issued in UT

Legal business name

SPENCE'S PRESCRIPTION PHARMACY INC

Practice address

550 E 1400 N
Logan, UT 84341-2406

Phone

(435) 753-8500

Fax

(435) 753-3040

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jared Stakebake, CPHT

Title

Cfo

Phone

(435) 753-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Spence's North Pharmacy Doing business as

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1902839715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E 1400 N",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412406",
            "telephone_number": "435-753-8500",
            "fax_number": "435-753-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E 1400 N",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412406",
            "telephone_number": "435-753-8500",
            "fax_number": "435-753-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCE'S PRESCRIPTION PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "STAKEBAKE",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "435-753-8500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "1259851703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870343085009",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spence's North Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Spainhower, DPT
• Kimberly Spear, SSW
• Specialty Sales & Service
• Specialty Sales & Service
• Spence'S Prescription Pharmacy
• Carrie Spencer, RN
• Danny E Spencer, DO
• Wesley Daniel Spencer
• Chad B Speth, FNP
• Becky L Spotten, CMHC, LPC

• Community/Retail Pharmacy in Logan, UT
• Providers in Logan, UT by specialty
• Community/Retail Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.