Healthcare Provider Details

I. General information

NPI: 1235613035
Provider Name (Legal Business Name): SAHIBA BEDI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5845 E AVE BLDG 412
HILL AFB UT
84056-5303
US

IV. Provider business mailing address

901 W EDINBURGH DR
NORTH SALT LAKE UT
84054-5072
US

V. Phone/Fax

Practice location:
  • Phone: 801-586-9530
  • Fax:
Mailing address:
  • Phone: 801-615-3646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8071123-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: