Healthcare Provider Details

I. General information

NPI: 1225942600
Provider Name (Legal Business Name): ZACHARY GONZALES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 E 11400 S
DRAPER UT
84020-9771
US

IV. Provider business mailing address

1641 E RED TREE CT
DRAPER UT
84020-7704
US

V. Phone/Fax

Practice location:
  • Phone: 801-495-7720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12019307-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: