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General NPI Number Information
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NPI Number | 1023366713
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Entity Type | Individual
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Provider Name | STEFEN RAY OSBORN PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 1171 W 2000 N
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City | LAYTON
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State | UT
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Zip | 84041-1638
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Country | US
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Telephone | 801-599-9161
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Fax |
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Provider Business Mailing Address
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Address Line | 82N 100E PO BOX 642
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City | COALVILLE
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State | UT
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Zip | 84017
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Country | US
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Telephone | 801-599-9161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6888375-1701
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License Number State | UT
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