Healthcare Provider Details

I. General information

NPI: 1376312900
Provider Name (Legal Business Name): LISA RICHARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 N REDWOOD RD
SARATOGA SPRINGS UT
84045-5190
US

IV. Provider business mailing address

689 N REDWOOD RD
SARATOGA SPRINGS UT
84045-5190
US

V. Phone/Fax

Practice location:
  • Phone: 385-374-5480
  • Fax:
Mailing address:
  • Phone: 385-374-5480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number7720759-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: