MEDICARE: NOLAN D BARNETT 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	4857889	UT

General Provider Information

NPI Number	:	1063794295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOLAN D BARNETT PHARMD

Provider Business Mailing Address
First Line	:	4646 W LAKE PARK BLVD
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-8212
Country	:	US
Telephone Number	:	385-297-6014
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 W LAKE PARK BLVD
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-8212
Country	:	US
Telephone Number	:	385-297-6014
Fax Number	:

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

Provider Enumeration Date	:	09/14/2011
Last Update Date	:	05/24/2024

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