Healthcare Provider Details

I. General information

NPI: 1902199235
Provider Name (Legal Business Name): KEVIN EVAN OLSON R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 W 400 S
SPRINGVILLE UT
84663-3061
US

IV. Provider business mailing address

1117 W 400 S
SPRINGVILLE UT
84663-3061
US

V. Phone/Fax

Practice location:
  • Phone: 385-685-7005
  • Fax: 385-685-7015
Mailing address:
  • Phone: 385-685-7005
  • Fax: 385-685-7015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number354429-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: