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General NPI Number Information
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NPI Number | 1578699278
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Entity Type | Individual
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Provider Name | CAROLYN G KOWALCHIK RPH
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | A050 UNIVERSITY HOSPITAL- PHARMACY 50 N MEDICAL DR
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City | SLC
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State | UT
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Zip | 84132-0001
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Country | US
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Telephone | 801-585-6704
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 BLUEBELL DR
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City | BOUNTIFUL
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State | UT
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Zip | 84010-1613
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Country | US
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Telephone | 801-585-6704
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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 | 147593-1701
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License Number State | UT
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