Healthcare Provider Details

I. General information

NPI: 1669950929
Provider Name (Legal Business Name): BROOKE TOPHAM HEAPS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5620 W 4100 S
WEST VALLEY CITY UT
84128-4338
US

IV. Provider business mailing address

7068 W HIGHTOWER RD
WEST JORDAN UT
84081
US

V. Phone/Fax

Practice location:
  • Phone: 801-966-6546
  • Fax: 801-966-6787
Mailing address:
  • Phone: 801-966-6546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9104456
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: