Provider Demographics
NPI:1750414314
Name:ISLAND VIEW PHARMACY INC
Entity type:Organization
Organization Name:ISLAND VIEW PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:801-773-7899
Mailing Address - Street 1:2038 W 1900 S
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-9320
Mailing Address - Country:US
Mailing Address - Phone:801-773-7899
Mailing Address - Fax:801-773-7338
Practice Address - Street 1:2038 W 1900 S
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-9320
Practice Address - Country:US
Practice Address - Phone:801-773-7899
Practice Address - Fax:801-773-7338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5108764-17033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========001Medicaid