Provider Demographics
NPI:1093285785
Name:RICHFIELD COMMUNITY PHARMACY LLC
Entity Type:Organization
Organization Name:RICHFIELD COMMUNITY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:VICKERS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:435-893-6808
Mailing Address - Street 1:91 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2648
Mailing Address - Country:US
Mailing Address - Phone:435-586-9651
Mailing Address - Fax:435-586-3473
Practice Address - Street 1:440 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701-2855
Practice Address - Country:US
Practice Address - Phone:435-893-6808
Practice Address - Fax:435-893-6809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy