Healthcare Provider Details

I. General information

NPI: 1265088314
Provider Name (Legal Business Name): ERIN ROSE HARTLEY MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 S MAIN ST
CEDAR CITY UT
84720-3548
US

IV. Provider business mailing address

1375 S 550 W
CEDAR CITY UT
84720-4332
US

V. Phone/Fax

Practice location:
  • Phone: 435-592-1490
  • Fax:
Mailing address:
  • Phone: 435-592-1490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: