Healthcare Provider Details

I. General information

NPI: 1912863994
Provider Name (Legal Business Name): ROUBA HOMSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 S 900 E
MURRAY UT
84117-7206
US

IV. Provider business mailing address

1220 E 3900 S STE 1H
MILLCREEK UT
84124-1327
US

V. Phone/Fax

Practice location:
  • Phone: 801-262-2981
  • Fax:
Mailing address:
  • Phone: 801-477-8304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7908526
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: