Healthcare Provider Details

I. General information

NPI: 1689519639
Provider Name (Legal Business Name): ERICA MARINI
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 S ARAPEEN DR
SALT LAKE CITY UT
84108-1218
US

IV. Provider business mailing address

2985 CAVE HOLLOW WAY
BOUNTIFUL UT
84010-1236
US

V. Phone/Fax

Practice location:
  • Phone: 801-587-8117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number8672900-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: