Healthcare Provider Details

I. General information

NPI: 1588589725
Provider Name (Legal Business Name): SAMANTHA GUBLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 W 1700 S
SYRACUSE UT
84075-9704
US

IV. Provider business mailing address

1676 E 1300 S
SALT LAKE CITY UT
84105-1704
US

V. Phone/Fax

Practice location:
  • Phone: 801-416-2323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10821497-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: