MEDICARE: DR. REZA SALMAN 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	2694811701	UT

General Provider Information

NPI Number	:	1972087328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REZA SALMAN PHARMD

Provider Business Mailing Address
First Line	:	1818 S 300 W
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-1805
Country	:	US
Telephone Number	:	801-485-9880
Fax Number	:

Provider Business Practice Location Address
First Line	:	4720 S FORTUNA WAY
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-5620
Country	:	US
Telephone Number	:	801-424-1242
Fax Number	:

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

Provider Enumeration Date	:	09/21/2018
Last Update Date	:	09/21/2018

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