Healthcare Provider Details

I. General information

NPI: 1396106373
Provider Name (Legal Business Name): ERIC VAWDREY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 N MAIN ST
HEBER CITY UT
84032-5515
US

IV. Provider business mailing address

744 N MAIN ST
HEBER CITY UT
84032-5515
US

V. Phone/Fax

Practice location:
  • Phone: 801-792-6813
  • Fax: 435-654-2890
Mailing address:
  • Phone: 801-792-6813
  • Fax: 435-654-2890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6432788-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: