Healthcare Provider Details

I. General information

NPI: 1306765086
Provider Name (Legal Business Name): ALBERT NUNEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3148 W 3500 S
WEST VALLEY UT
84119-3634
US

IV. Provider business mailing address

3762 S 1300 E
SALT LAKE CITY UT
84106-2959
US

V. Phone/Fax

Practice location:
  • Phone: 801-963-2389
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number11119974-1717
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: