# CENTRAL VALLEY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CENTRAL VALLEY COMMUNITY PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902825854
- **Authorized official:** BRENT DAVIS RPH (CFO)
- **Authorized official phone:** (435) 623-3000

## Contact information

- **Practice address:** 152 W 1500 N, NEPHI, UT 84648-5520
- **Practice address phone:** (435) 623-3700
- **Practice address fax:** (435) 623-3704
- **Mailing address:** PO BOX 412, NEPHI, UT 84648-0412
- **Mailing address fax:** (435) 623-3704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 62330861703 | UT | Yes |

## Other

- **Enumeration date:** 07/19/2006
- **Last updated:** 12/20/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2100851 | PK | — |