MEDICARE: HEATH LAMOREAUX

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	5304530-1701	UT

General Provider Information

NPI Number	:	1124620521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATH LAMOREAUX

Provider Business Mailing Address
First Line	:	PO BOX 9211
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-0211
Country	:	US
Telephone Number	:	801-815-0551
Fax Number	:

Provider Business Practice Location Address
First Line	:	6545 N LANDMARK DR
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84098-5990
Country	:	US
Telephone Number	:	435-647-9050
Fax Number	:	435-647-9042

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

Provider Enumeration Date	:	11/10/2020
Last Update Date	:	11/10/2020

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Directions to “ HEATH LAMOREAUX ” Practice Location

Language	Start Address	Practice Location

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