Healthcare Provider Details

I. General information

NPI: 1902726607
Provider Name (Legal Business Name): ERIN AYCOX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7227 S STATE ST
MIDVALE UT
84047-2061
US

IV. Provider business mailing address

4714 S MC CALLAN WAY
MURRAY UT
84107-1472
US

V. Phone/Fax

Practice location:
  • Phone: 801-307-0494
  • Fax:
Mailing address:
  • Phone: 281-614-9381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14291558-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: