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General NPI Number Information
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NPI Number | 1700430865
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Entity Type | Individual
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Provider Name | BRYAN REED MCHARGUE
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Gender | Male
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Dates
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Enumeration Date | 07/27/2019
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Last Update Date | 07/27/2019
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Provider Practice Location Address
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Address Line | 931 W STATE RD
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2102
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Country | US
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Telephone | 801-796-6580
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Fax | 801-795-0760
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Provider Business Mailing Address
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Address Line | 1510 W 1200 N
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City | MAPLETON
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State | UT
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Zip | 84664-3204
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Country | US
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Telephone | 801-367-1660
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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 | 501326-1701
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License Number State | UT
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