Healthcare Provider Details

I. General information

NPI: 1407773906
Provider Name (Legal Business Name): CARSON MICHAEL LASATER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5056 W 13400 S
HERRIMAN UT
84096-6600
US

IV. Provider business mailing address

5443 W AUTUMN CREEK DR
RIVERTON UT
84096-6568
US

V. Phone/Fax

Practice location:
  • Phone: 801-981-1680
  • Fax: 801-981-1677
Mailing address:
  • Phone: 801-981-1680
  • Fax: 801-981-1677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11437307-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: