MEDICARE: PIPER BUTCHER

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
1	183500000X	Pharmacist	132490-1701	UT

General Provider Information

NPI Number	:	1417231127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIPER BUTCHER

Provider Business Mailing Address
First Line	:	1998 GLACIER VIEW DR
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84092-5603
Country	:	US
Telephone Number	:	801-572-7899
Fax Number	:

Provider Business Practice Location Address
First Line	:	9400 SOUTH 700 EAST
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84092-5603
Country	:	US
Telephone Number	:	801-307-0071
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	09/30/2011

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Directions to “ PIPER BUTCHER ” Practice Location

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