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General NPI Number Information
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NPI Number | 1558817544
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF UTAH
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 165 N UNIVERSITY AVE RM 102
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City | FARMINGTON
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State | UT
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Zip | 84025-2990
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Country | US
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Telephone | 801-213-6310
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Fax | 801-213-6603
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Provider Business Mailing Address
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Address Line | PO BOX 841208
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City | LOS ANGELES
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State | CA
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Zip | 90084-1124
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Country | US
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Telephone | 801-587-6334
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Fax | 801-587-2996
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Authorized Official
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Title or Position | PHARMACY BUSINESS OPERATION MANAGER
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Name | KELLEE K HOWELL
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Credential | CPHT
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Telephone | 801-587-6334
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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 | 9894237-1703
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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