MEDICARE: BRANDON BUI

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	9523009-1701	UT

General Provider Information

NPI Number	:	1417566829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON BUI

Provider Business Mailing Address
First Line	:	3683 W SPRING VISTA DR
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-3345
Country	:	US
Telephone Number	:	801-946-5486
Fax Number	:

Provider Business Practice Location Address
First Line	:	4668 S REDWOOD RD
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84123-5687
Country	:	US
Telephone Number	:	801-946-5486
Fax Number	:

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

Provider Enumeration Date	:	07/31/2020
Last Update Date	:	07/31/2020

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Directions to “ BRANDON BUI ” Practice Location

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