Healthcare Provider Details

I. General information

NPI: 1801290986
Provider Name (Legal Business Name): JEFFERY ZOBELL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MARIO CAPECCHI DR
SALT LAKE CITY UT
84113-1103
US

IV. Provider business mailing address

100 MARIO CAPECCHI DR
SALT LAKE CITY UT
84113-1103
US

V. Phone/Fax

Practice location:
  • Phone: 801-662-2641
  • Fax: 801-662-2622
Mailing address:
  • Phone: 801-662-2641
  • Fax: 801-662-2622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6193395-1701
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number6193395-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: