Healthcare Provider Details

I. General information

NPI: 1508819814
Provider Name (Legal Business Name): BETH MCCARTHY PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1743 REDSTONE CENTER DR SUITE 115
PARK CITY UT
84098-7600
US

IV. Provider business mailing address

7974 SPRINGSHIRE DR
PARK CITY UT
84098-5396
US

V. Phone/Fax

Practice location:
  • Phone: 435-658-9280
  • Fax:
Mailing address:
  • Phone: 435-655-0180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5234797-1701
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5055
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: