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NPI 1104464692

NPI 1104464692 : MICHAEL JOHN TOPOLOVEC PHARMACIST : LEHI, UT

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General NPI Number Information
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    NPI Number           |    1104464692
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL JOHN TOPOLOVEC PHARMACIST
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/15/2019
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    Last Update Date     |    12/15/2019
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Provider Practice Location Address
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    Address Line         |    1550 E 3500 N 
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    City                 |    LEHI
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    State                |    UT
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    Zip                  |    84043-3530
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    Country              |    US
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    Telephone            |    801-341-6515
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    Fax                  |    801-341-6516
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Provider Business Mailing Address
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    Address Line         |    1550 E 3500 N 
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    City                 |    LEHI
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    State                |    UT
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    Zip                  |    84043-3530
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    Country              |    US
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    Telephone            |    801-341-6515
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    Fax                  |    801-341-6516
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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        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    
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    License Number State |    
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