Healthcare Provider Details

I. General information

NPI: 1063057529
Provider Name (Legal Business Name): JULIE PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 N HIGHWAY 89
FARMINGTON UT
84025-3841
US

IV. Provider business mailing address

1594 TUSCANY COVE DR
FARMINGTON UT
84025-2049
US

V. Phone/Fax

Practice location:
  • Phone: 801-451-2900
  • Fax: 801-451-7607
Mailing address:
  • Phone: 801-726-0654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number260332-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: