# SPANISH VALLEY CLINIC PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SAN JUAN HEALTH SERVICE DISTRICT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114597853
- **Legal business name:** SAN JUAN HEALTH SERVICE DISTRICT
- **Authorized official:** BRIAN JOSEPH BOTHWELL PHARM D (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (435) 587-2116

## Contact information

- **Practice address:** 5555 OLD AIRPORT RD., SPANISH VALLEY, UT 84532
- **Practice address phone:** (435) 587-1181
- **Mailing address:** 380 W 100 N, PO BOX 308, MONTICELLO, UT 84535
- **Mailing address phone:** (435) 587-2116
- **Mailing address fax:** (435) 587-3329

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/25/2021
- **Last updated:** 11/16/2023