Organization Name: | VILLAGE PANTRY #9 |
NPI Number: | 1558406181 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL JOHNSON (OWNER AND PHARMACIST) |
Mailing Address: | 405 S Main St Springville |
State: | UT US |
Postal Code: | 846632252 |
Phone Number: | 8014895618 |
Fax Number: | 8014890441 |
NPI Enumeration Date: | 02/21/2007 |
NPI Last Update Date: | 11/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |