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NPI Code Detail

MEDICARE: MR. TOMMY JOSEPH WILLIAMS R.PH., P.D.

MEDICARE: MR. TOMMY JOSEPH WILLIAMS R.PH., P.D.
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
1183500000XPharmacist146548-1701UT

General Provider Information

NPI Number : 1467440099
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TOMMY JOSEPH WILLIAMS R.PH., P.D.
Provider Business Mailing Address
First Line : 1352 VALLEY RIDGE DR
Second Line :
City : SANDY
State : UT
Zip : 84093-6651
Country : US
Telephone Number : 801-565-0376
Fax Number : 801-982-1351
Provider Business Practice Location Address
First Line : 4188 W 5415 S
Second Line :
City : KEARNS
State : UT
Zip : 84118-4310
Country : US
Telephone Number : 801-969-1986
Fax Number : 801-982-1351
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 07/08/2007

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