Provider Demographics
NPI:1285902973
Name:T.C.L.F. LLC
Entity type:Organization
Organization Name:T.C.L.F. LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-734-9565
Mailing Address - Street 1:580 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-1733
Mailing Address - Country:US
Mailing Address - Phone:801-773-8700
Mailing Address - Fax:801-773-8787
Practice Address - Street 1:580 S STATE ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-1733
Practice Address - Country:US
Practice Address - Phone:801-773-8700
Practice Address - Fax:801-773-8787
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:T.C.L.F. LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-08
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty