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NPI Code Detail

MEDICARE: DR. BRIAN HATHAWAY PHARMD

MEDICARE: DR. BRIAN HATHAWAY 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
11835I0206XInfectious Diseases Pharmacist6976690-1701UT

General Provider Information

NPI Number : 1093667925
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN HATHAWAY PHARMD
Provider Business Mailing Address
First Line : 1936 E HUBBARD AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1304
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 E 3900 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-1300
Country : US
Telephone Number : 801-268-7111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/12/2026

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