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NPI Code Detail

MEDICARE: MR. WILLIAM DELL CRAYNOR R. PH.

MEDICARE: MR. WILLIAM DELL CRAYNOR R. PH.
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
1183500000XPharmacist140651-1701UT

General Provider Information

NPI Number : 1689654329
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM DELL CRAYNOR R. PH.
Provider Business Mailing Address
First Line : 134 COTTONWOOD DR
Second Line :
City : OGDEN
State : UT
Zip : 84414-1180
Country : US
Telephone Number : 801-595-4375
Fax Number : 801-595-2075
Provider Business Practice Location Address
First Line : 1040 N 2200 W
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84116-2905
Country : US
Telephone Number : 801-595-4375
Fax Number : 801-595-2075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 11/01/2007

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