MEDICARE: KIMBERLY KAY KEEFER-HICKS PHARMD

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	5474882-1701	UT

General Provider Information

NPI Number	:	1417839168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY KAY KEEFER-HICKS PHARMD

Provider Business Mailing Address
First Line	:	1360 S FOOTHILL DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-2321
Country	:	US
Telephone Number	:	801-581-1700
Fax Number	:	801-581-1704

Provider Business Practice Location Address
First Line	:	1360 S FOOTHILL DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-2321
Country	:	US
Telephone Number	:	801-581-1700
Fax Number	:	801-581-1704

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

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	07/23/2025

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Directions to “ KIMBERLY KAY KEEFER-HICKS PHARMD” Practice Location

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