# EJVF LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BULLOCHS DRUG STORE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598776080
- **Authorized official:** ROBERT VICKERS (PRESIDENT)
- **Authorized official phone:** (435) 586-9651

## Contact information

- **Practice address:** 91 N MAIN ST, CEDAR CITY, UT 84720-2648
- **Practice address phone:** (435) 586-9651
- **Practice address fax:** (435) 586-3473
- **Mailing address:** 91 N MAIN ST, CEDAR CITY, UT 84720-2648
- **Mailing address phone:** (435) 586-9651
- **Mailing address fax:** (435) 586-3473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 314272-1703 | UT | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 06/14/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1402009 | — | UT |
| 01 | — | 2106943 | PK | — |