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Organization
EJVF LLC
Active
Organization
EJVF LLC
Active
Other names
BULLOCHS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT VICKERS (PRESIDENT)
(435) 586-9651
Entity
Organization
Contact information
Practice address
91 N MAIN ST, CEDAR CITY, UT 84720-2648
(435) 586-9651
(435) 586-3473
Mailing address
91 N MAIN ST, CEDAR CITY, UT 84720-2648
(435) 586-9651
(435) 586-3473
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
314272-1703
UT
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1402009
—
UT
01
—
2106943
PK
—
Enumeration date
08/10/2006
Last updated
06/14/2022
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