Provider Demographics
NPI:1184134819
Name:PHARMBOY VENTURES UNLIMITED INC
Entity type:Organization
Organization Name:PHARMBOY VENTURES UNLIMITED INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-255-7160
Mailing Address - Street 1:2376 RED CLIFFS DR STE 377
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8367
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2376 E RED CLIFFS DRIVE
Practice Address - Street 2:SUITE 377
Practice Address - City:ST. GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790
Practice Address - Country:US
Practice Address - Phone:435-255-7160
Practice Address - Fax:435-255-7202
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMBOY VENTURES UNLIMITED INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-09
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10527986-17033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy