Provider Demographics
NPI:1073120515
Name:COUNTY OF CACHE
Entity Type:Organization
Organization Name:COUNTY OF CACHE
Other - Org Name:CACHE COUNTY CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNTY EXECUTIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:W
Authorized Official - Last Name:BUTTARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-755-1850
Mailing Address - Street 1:179 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-4527
Mailing Address - Country:US
Mailing Address - Phone:435-755-1670
Mailing Address - Fax:
Practice Address - Street 1:46 N 100 W
Practice Address - Street 2:
Practice Address - City:HYRUM
Practice Address - State:UT
Practice Address - Zip Code:84319-1228
Practice Address - Country:US
Practice Address - Phone:435-755-1670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance