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General NPI Number Information
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NPI Number | 1235023698
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Entity Type | Individual
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Provider Name | JARED ALEX GONZALEZ PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 497 W 4800 S STE 100
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City | MURRAY
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State | UT
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Zip | 84123-4749
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Country | US
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Telephone | 801-810-0337
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Fax | 801-312-8760
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Provider Business Mailing Address
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Address Line | 497 W 4800 S STE 100
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City | MURRAY
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State | UT
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Zip | 84123-4749
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Country | US
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Telephone | 801-810-0337
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Fax | 801-801-3128
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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 | PHA.0025138
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 8786745-1701
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License Number State | UT
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