Organization
BVP LLC
Active
Other names
City Drug of Bridger Valley
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW CANNON RPH (MANAGING MEMBER)
(307) 789-4000
Entity
Organization
Contact information
Practice address
950 N HWY 414, MOUNTAIN VIEW, WY 82939
(307) 782-3784
(307) 782-3785
Mailing address
PO BOX 1699, EVANSTON, WY 82931
(307) 782-3784
(307) 782-3785
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153007100
—
WY
01
—
R10181
STATE PHARMACY LICENSE
WY
Enumeration date
03/21/2019
Last updated
01/05/2021
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