1528020815 NPI number — ALMA JOYCE CAVINESS REGISTERED PHARMACIS

Table of content: ALMA JOYCE CAVINESS REGISTERED PHARMACIS (NPI 1528020815)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528020815 NPI number — ALMA JOYCE CAVINESS REGISTERED PHARMACIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAVINESS
Provider First Name:
ALMA
Provider Middle Name:
JOYCE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
REGISTERED PHARMACIS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528020815
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
337 DENVER AVE.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST CARBON
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84520-0879
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-888-0323
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
305 CENTER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST CARBON
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84520-0930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-888-4411
Provider Business Practice Location Address Fax Number:
435-888-2270
Provider Enumeration Date:
04/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  287009-8911 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com