Healthcare Provider Details

I. General information

NPI: 1265211221
Provider Name (Legal Business Name): BRIGHTSIDE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4227 S HIGHLAND DR STE 7
HOLLADAY UT
84124-2672
US

IV. Provider business mailing address

4227 S HIGHLAND DR STE 7
HOLLADAY UT
84124-2672
US

V. Phone/Fax

Practice location:
  • Phone: 435-200-9965
  • Fax: 801-553-2540
Mailing address:
  • Phone: 435-200-9965
  • Fax: 801-553-2540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CODY WALKER
Title or Position: OWNER
Credential: PHARMACIST
Phone: 435-200-9965