Healthcare Provider Details

I. General information

NPI: 1902115355
Provider Name (Legal Business Name): ERIC W JOHNSON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 W 1700 S
SYRACUSE UT
84075-9127
US

IV. Provider business mailing address

3810 W 3550 S
WEST HAVEN UT
84401-9343
US

V. Phone/Fax

Practice location:
  • Phone: 801-773-5373
  • Fax:
Mailing address:
  • Phone: 801-648-3769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6568338-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: