Healthcare Provider Details

I. General information

NPI: 1265369854
Provider Name (Legal Business Name): LIZABETH ANNE COWGILL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIZABETH ANNE STOLLEY

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 W 600 N
SALT LAKE CITY UT
84116-2707
US

IV. Provider business mailing address

805 W 600 N
SALT LAKE CITY UT
84116-2707
US

V. Phone/Fax

Practice location:
  • Phone: 801-834-5771
  • Fax:
Mailing address:
  • Phone: 801-484-7362
  • Fax: 801-484-8658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number12341120-1702
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: