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General NPI Number Information
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NPI Number | 1700764651
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Entity Type | Individual
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Provider Name | NOOSHIN H PRASTHOFER RPH
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Gender | Female
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 6306 S AIRPORT RD
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City | WEST JORDAN
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State | UT
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Zip | 84084-5601
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Country | US
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Telephone | 801-432-5300
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Fax | 801-708-1175
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Provider Business Mailing Address
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Address Line | PO BOX 91044
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-1044
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Country | US
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Telephone | 801-708-1175
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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 | 9801266-1701
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License Number State | UT
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