MEDICARE: JIM DIX PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	374025-1701	UT

General Provider Information

NPI Number	:	1023999471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIM DIX PHARMD

Provider Business Mailing Address
First Line	:	1760 PARK AVE
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84060-5125
Country	:	US
Telephone Number	:	435-649-6264
Fax Number	:	435-655-7176

Provider Business Practice Location Address
First Line	:	1760 PARK AVE
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84060-5125
Country	:	US
Telephone Number	:	435-649-6264
Fax Number	:	435-655-7176

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2025
Last Update Date	:	09/11/2025

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Directions to “ JIM DIX PHARMD” Practice Location

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