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General NPI Number Information
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NPI Number | 1407714017
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Entity Type | Individual
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Provider Name | BROOKE PULKRABEK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 2483 N MAIN ST
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City | TOOELE
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State | UT
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Zip | 84074-3641
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Country | US
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Telephone | 435-241-5145
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Fax |
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Provider Business Mailing Address
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Address Line | 402 TRIPLE CROWN WAY
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City | GRANTSVILLE
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State | UT
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Zip | 84029-9425
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Country | US
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Telephone | 435-830-3251
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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 | 9180106-1701
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License Number State | UT
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