MEDICARE: SCOTT WALTER MARSHALL 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	333852-1701	UT

General Provider Information

NPI Number	:	1548455488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT WALTER MARSHALL PHARMD

Provider Business Mailing Address
First Line	:	1561 E PARKWAY AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-3525
Country	:	US
Telephone Number	:	801-587-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	585 KOMAS DR
Second Line	:	SUITE 200
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1231
Country	:	US
Telephone Number	:	801-587-0600
Fax Number	:

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

Provider Enumeration Date	:	09/13/2007
Last Update Date	:	09/13/2007

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