Healthcare Provider Details

I. General information

NPI: 1346968799
Provider Name (Legal Business Name): DANIEL ROUNDY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1189 E 700 S
SAINT GEORGE UT
84790-4022
US

IV. Provider business mailing address

1189 E 700 S
SAINT GEORGE UT
84790-4022
US

V. Phone/Fax

Practice location:
  • Phone: 435-628-2824
  • Fax: 435-656-6246
Mailing address:
  • Phone: 435-628-2824
  • Fax: 435-656-6246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11607555-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: