Provider Demographics
NPI:1285433839
Name:CACHE VALLEY PHARMACARE LLC
Entity type:Organization
Organization Name:CACHE VALLEY PHARMACARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECH/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:COWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-787-1212
Mailing Address - Street 1:2245 N 400 E STE 105
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-1785
Mailing Address - Country:US
Mailing Address - Phone:435-787-1212
Mailing Address - Fax:435-787-1922
Practice Address - Street 1:2245 N 400 E STE 105
Practice Address - Street 2:
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-1785
Practice Address - Country:US
Practice Address - Phone:435-787-1212
Practice Address - Fax:435-787-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy