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NPI Code Detail

MEDICARE: DR. JEFFERY L. OLSON PHARMD, BCPS

MEDICARE: DR. JEFFERY L. OLSON PHARMD, BCPS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH00056436WA
2183500000XPharmacist4854022-1701UT

General Provider Information

NPI Number : 1104858083
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFERY L. OLSON PHARMD, BCPS
Provider Business Mailing Address
First Line : 7302 S BINGHAM JUNCTION BLVD
Second Line :
City : MIDVALE
State : UT
Zip : 84047-4804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7302 S BINGHAM JUNCTION BLVD
Second Line :
City : MIDVALE
State : UT
Zip : 84047-4804
Country : US
Telephone Number : 801-442-4599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 08/22/2016

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