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NPI Code Detail

MEDICARE: MR. JAMES WILLIAM DAHL RPH

MEDICARE: MR. JAMES WILLIAM DAHL RPH
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
1183500000XPharmacist144814-1701UT

General Provider Information

NPI Number : 1063704120
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES WILLIAM DAHL RPH
Provider Business Mailing Address
First Line : 765 E 6410 S
Second Line :
City : MURRAY
State : UT
Zip : 84107-7754
Country : US
Telephone Number : 801-264-8246
Fax Number :
Provider Business Practice Location Address
First Line : 2332 E 2100 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-1319
Country : US
Telephone Number : 801-466-9949
Fax Number : 801-467-6742
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2011
Last Update Date : 05/09/2011

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