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NPI Code Detail

MEDICARE: NIEL RYAN HARMON

MEDICARE:   NIEL RYAN HARMON
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
1183500000XPharmacist6098123-1701UT

General Provider Information

NPI Number : 1861093213
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIEL RYAN HARMON
Provider Business Mailing Address
First Line : 14658 S WINDY RIDGE CIR
Second Line :
City : HERRIMAN
State : UT
Zip : 84096-4701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11278 S JORDAN GTWY
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-4111
Country : US
Telephone Number : 801-545-9815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2020
Last Update Date : 11/03/2020

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Directions to “ NIEL RYAN HARMON ” Practice Location

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