Organization
PIONEER DRUG LLC
Active
Other names
Cedar Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHELDON BIRCH PHARMD (MANAGING MEMBER/PHARMACIST)
(435) 882-7775
Entity
Organization
Contact information
Practice address
3435 E PONY EXPRESS PARKWAY, SUITE 150, EAGLE MOUNTAIN, UT 84005
(801) 753-5100
(801) 753-5101
Mailing address
4776 AUTUMN CV, ERDA, UT 84074-5548
(435) 882-7775
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689238479
MEDICARE
UT
05
—
1689238479
—
UT
Enumeration date
04/26/2019
Last updated
08/24/2023
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