SKULL VALLEY HEALTH CLINIC (NPI# 1528525508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528525508 |
| Entity Type | Organization |
| Organization Name | SKULL VALLEY HEALTH CLINIC |
| Practice Address |
1929 N Aaron Dr Ste I Tooele UT 84074-8112 |
| Practice Telephone | 4358501825 |
| Practice Fax Number | 8448474640 |
| Mailing Telephone | 4358501825 |
| Mailing Fax Number | 8448474640 |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-02-26 |
| Authorized Official Name | CIMA GHAFFARIAN (DIRECTOR) |
| Authorized Official Telephone | 4358501825 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | Y |
| Parent Organization Name | SKULL VALLEY HEALTH CLINIC INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Skull Valley Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710468384 | Skull Valley Health Clinic | Clinic/Center | 1929 Aaron Dr Ste I, Tooele, UT 84074-8112 | 2018-08-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SKULL VALLEY HEALTH CLINIC, INC. | 1929 N Aaron Dr Ste I, Tooele, UT 84074-8112 |
| Street Address |
1929 N AARON DR STE I |
| City | TOOELE |
| State | UT |
| Zip Code | 84074-8112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134761133 | Jameson Hedin | Social Worker | 1929 N Aaron Dr Ste I, Tooele, UT 84074-8112 | 2019-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233397 | Leah Elizabeth Harper I | Behavior Technician | 39 Millpond Stansbury Park, Tooele, UT 84074 | 2019-06-07 |
| 1245710789 | Tanna Marie Shelley | Community Health Worker | 27 So Main St, Tooele, UT 84074 | 2018-08-15 |
| 1528548062 | Barbara T Cederlof | Community Health Worker | 27 South Main St., Tooele, UT 84074 | 2018-08-15 |
| 1235615600 | Ashley Christine Wilson | Case Manager/Care Coordinator | 27 South Main, Tooele, UT 84074 | 2018-07-18 |
| 1174016976 | Makenzie Green | Case Manager/Care Coordinator | 27 S Main, Tooele, UT 84074 | 2018-06-07 |
| 1386151835 | Monica Lee | Physical Therapist | 6727 Ut-36 #300, Stansbury Park, UT 84074 | 2018-01-05 |
| 1871976183 | Pagnani Physical Therapy | Physical Therapist | 6727 North State Hwy 36, Suite 300, Stansbury Park, UT 84074 | 2015-07-06 |
| 1407248222 | Pebble Creek Counseling Center | Counselor | 494 E 2400 N Ste B, Tooele, UT 84074 | 2015-03-03 |
| 1528496221 | Emily Carlson | Case Manager/Care Coordinator | 220 North Millpond Rd, Suite 100, Stansbury Park, UT 84074 | 2013-10-16 |
| 1710327218 | Angela Michelle Demoss | Nurse Practitioner | 682 Country Club, Stansbury Park, UT 84074 | 2013-06-28 |
| Find all providers in zip 84074 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063853547 | Holt's Pharmacy | Pharmacy | 134 W 1180 N Ste 12, Tooele, UT 84074-1483 | 2013-07-11 |
| 1861780439 | Birch Pharmaceutical LLC | Pharmacy | 6727 N. Hwy 36, Tooele, UT 84074 | 2011-07-18 |
| 1790920700 | Rsp Pharmaceutical Corporation | Pharmacy | 493 N Main St, Tooele, UT 84074 | 2008-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093502 | Alan Keith Bennion | Pharmacy | 5761 S Surreyrun Rd, Murray, UT 84107-6610 | 2020-11-07 |
| 1558919142 | University of Utah | Pharmacy | 1280 E. Stringham Ave, Suite 101, Salt Lake City, UT 84106 | 2019-08-28 |
| 1639649916 | Midland Pharmacy, LLC | Pharmacy | 4815 S 3500 W, Roy, UT 84067-9439 | 2018-11-29 |
| 1235628223 | Meds In Motion, LLC | Pharmacy | 12101 S State St, Suite 101a, Draper, UT 84120 | 2018-05-04 |
| 1114439775 | Fusion Pharmacy LLC | Pharmacy | 617 E Riverside Dr Ste 104, St George, UT 84790 | 2017-11-03 |
| 1568973055 | Eco Apothecary LLC | Pharmacy | 3701 S State Street Suite 114, South Salt Lake City, UT 84115 | 2017-10-24 |
| 1770021388 | Crimson Valley Pharmacy LLC | Pharmacy | 2351 S River Rd, Ste 3, Saint George, UT 84790-8280 | 2017-02-02 |
| 1013454396 | Gfy LLC | Pharmacy | 189 S State St Ste 120, Clearfield, UT 84015-1062 | 2017-01-25 |
| 1083157382 | Badger Management LLC | Pharmacy | 725 N Redwood Road, N Salt Lake, UT 84054 | 2016-11-18 |
| 1881143444 | Premier Medical Distribution | Pharmacy | 12393 S Gateway Park Pl, Suite 75, Draper, UT 84020-2309 | 2016-09-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.