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NPI Code Detail

MEDICARE: JOHN HEATH R.PH.

MEDICARE: JOHN HEATH 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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist266074-1701UT
2183500000XPharmacist266074-1701UT

General Provider Information

NPI Number : 1780975649
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN HEATH R.PH.
Provider Business Mailing Address
First Line : 457 N 300 W
Second Line :
City : SLC
State : UT
Zip : 84103-1220
Country : US
Telephone Number : 801-598-1669
Fax Number : 801-485-9821
Provider Business Practice Location Address
First Line : 1818 S 300 W
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-1805
Country : US
Telephone Number : 801-485-9885
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2011
Last Update Date : 07/18/2019

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