Provider Demographics
NPI:1154683605
Name:LOVELL PHARMACY LLC
Entity Type:Organization
Organization Name:LOVELL PHARMACY LLC
Other - Org Name:LOVELL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANI
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:435-864-5122
Mailing Address - Street 1:111 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:UT
Mailing Address - Zip Code:84624-8497
Mailing Address - Country:US
Mailing Address - Phone:435-864-5122
Mailing Address - Fax:435-864-2706
Practice Address - Street 1:111 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:UT
Practice Address - Zip Code:84624-8497
Practice Address - Country:US
Practice Address - Phone:435-864-5122
Practice Address - Fax:435-864-2706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT83009161703333600000X
UT83009168913333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy