Healthcare Provider Details

I. General information

NPI: 1114575479
Provider Name (Legal Business Name): KARSTEN MICHAEL JOSIE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 E CENTER ST
KANAB UT
84741-3542
US

IV. Provider business mailing address

560 WINCHESTER ST
KANAB UT
84741-3000
US

V. Phone/Fax

Practice location:
  • Phone: 435-644-2693
  • Fax: 435-644-2702
Mailing address:
  • Phone: 435-690-9253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8627231-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: