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General NPI Number Information
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NPI Number | 1407773906
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Entity Type | Individual
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Provider Name | CARSON MICHAEL LASATER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2026
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Last Update Date | 07/04/2026
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Provider Practice Location Address
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Address Line | 5056 W 13400 S
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City | HERRIMAN
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State | UT
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Zip | 84096-6600
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Country | US
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Telephone | 801-981-1680
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Fax | 801-981-1677
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Provider Business Mailing Address
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Address Line | 5443 W AUTUMN CREEK DR
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City | RIVERTON
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State | UT
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Zip | 84096-6568
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Country | US
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Telephone | 801-981-1680
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Fax | 801-981-1677
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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 | 11437307-1701
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License Number State | UT
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