# SPENCE'S PRESCRIPTION PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Spence's North Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902839715
- **Authorized official:** MR. JARED STAKEBAKE CPHT (CFO)
- **Authorized official phone:** (435) 753-8500

## Contact information

- **Practice address:** 550 E 1400 N, LOGAN, UT 84341-2406
- **Practice address phone:** (435) 753-8500
- **Practice address fax:** (435) 753-3040
- **Mailing address:** 550 E 1400 N, LOGAN, UT 84341-2406
- **Mailing address phone:** (435) 753-8500
- **Mailing address fax:** (435) 753-3040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 1259851703 | UT | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 12/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 870343085009 | — | UT |