Healthcare Provider Details

I. General information

NPI: 1063738268
Provider Name (Legal Business Name): BRADY TED SMITH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N MAIN ST
RICHFIELD UT
84701-1857
US

IV. Provider business mailing address

1000 N MAIN ST
RICHFIELD UT
84701-2061
US

V. Phone/Fax

Practice location:
  • Phone: 435-893-0232
  • Fax: 435-893-0231
Mailing address:
  • Phone: 435-893-0232
  • Fax: 435-893-0231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4601
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5252155-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: