Healthcare Provider Details

I. General information

NPI: 1225600513
Provider Name (Legal Business Name): HEIDI MICHELLE SCHILLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9103 S 1300 W STE 102
WEST JORDAN UT
84088-6709
US

IV. Provider business mailing address

PO BOX 565
COALVILLE UT
84017-0565
US

V. Phone/Fax

Practice location:
  • Phone: 801-893-0033
  • Fax: 385-351-9425
Mailing address:
  • Phone: 435-901-0806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5726204-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: