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General NPI Number Information
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NPI Number | 1619446309
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Entity Type | Individual
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Provider Name | SOPHIA ANN ENTRINGER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/25/2018
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Last Update Date | 11/25/2018
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Provider Practice Location Address
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Address Line | 4393 S RIVERBOAT RD
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City | TAYLORSVILLE
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State | UT
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Zip | 84123-2503
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Country | US
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Telephone | 801-284-1042
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Fax |
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Provider Business Mailing Address
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Address Line | 2725 S 700 E APT K
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City | SALT LAKE CITY
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State | UT
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Zip | 84106-2883
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Country | US
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Telephone | 434-386-1518
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 7999752-1701
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License Number State | UT
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