Healthcare Provider Details

I. General information

NPI: 1043526346
Provider Name (Legal Business Name): NAIDA SEHOVIC RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2010
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2332 E 2100 S
SLC UT
84109-1319
US

IV. Provider business mailing address

497 MONTE C CT
SALT LAKE CITY UT
84115-4363
US

V. Phone/Fax

Practice location:
  • Phone: 801-466-9949
  • Fax:
Mailing address:
  • Phone: 801-671-2085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60915251701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: