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General NPI Number Information
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NPI Number | 1295017630
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Entity Type | Individual
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Provider Name | COY MCAFFEE PHARMD, RPH
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Gender | Male
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Dates
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Enumeration Date | 09/12/2011
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 176 E 13800 S
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City | DRAPER
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State | UT
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Zip | 84020-9548
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Country | US
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Telephone | 801-307-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 12101 KAITLYN CIR
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City | DRAPER
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State | UT
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Zip | 84020-8446
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Country | US
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Telephone | 801-523-5979
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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 | 152031-1701
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License Number State | UT
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