Healthcare Provider Details

I. General information

NPI: 1275743015
Provider Name (Legal Business Name): GARY L DURFEY RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N MAIN ST
LOGAN UT
84341-1918
US

IV. Provider business mailing address

878 N 6400 W
MENDON UT
84325-9728
US

V. Phone/Fax

Practice location:
  • Phone: 435-753-0990
  • Fax: 435-753-1969
Mailing address:
  • Phone: 435-713-0445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number273996-1701
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP5295
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13994
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: