| NPI | 1114024957 |
|---|---|
| Doing Business As | LTC OF CACHE VALLEY |
| Entity Type | Organization |
| Authorized Contact | PHILLIP COWLEY Owner 435-787-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: UT 61935351704) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |