Provider Demographics
NPI:1548364516
Name:KAMAS FOOD INC
Entity type:Organization
Organization Name:KAMAS FOOD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TANNER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:435-783-4369
Mailing Address - Street 1:PO BOX 560
Mailing Address - Street 2:
Mailing Address - City:KAMAS
Mailing Address - State:UT
Mailing Address - Zip Code:84036-0560
Mailing Address - Country:US
Mailing Address - Phone:435-783-4316
Mailing Address - Fax:435-783-4370
Practice Address - Street 1:146 W 200 S
Practice Address - Street 2:
Practice Address - City:KAMAS
Practice Address - State:UT
Practice Address - Zip Code:84036
Practice Address - Country:US
Practice Address - Phone:435-783-4316
Practice Address - Fax:435-783-4370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6206816-17033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4610603OtherNCPDP PROVIDER IDENTIFICATION NUMBER
4610603OtherNCPDP PROVIDER IDENTIFICATION NUMBER