Healthcare Provider Details

I. General information

NPI: 1730015439
Provider Name (Legal Business Name): NICHOLAS WARD KILLPACK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W MAIN ST
DELTA UT
84624-9257
US

IV. Provider business mailing address

215 W MAIN ST
DELTA UT
84624-9257
US

V. Phone/Fax

Practice location:
  • Phone: 435-864-2545
  • Fax: 435-864-5925
Mailing address:
  • Phone: 435-864-2545
  • Fax: 435-864-5925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5568957
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: