Healthcare Provider Details

I. General information

NPI: 1922331909
Provider Name (Legal Business Name): JENNIFER MARIE HOFFMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GRECC 182 500 FOOTHILL DRIVE
SALT LAKE CITY UT
84148-0001
US

IV. Provider business mailing address

GRECC 182 500 FOOTHILL DRIVE
SALT LAKE CITY UT
84148-0001
US

V. Phone/Fax

Practice location:
  • Phone: 801-582-1565
  • Fax:
Mailing address:
  • Phone: 801-582-1565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number374882-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: