MEDICARE: MCKINZIE JONES

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	9428507-1701	UT

General Provider Information

NPI Number	:	1144832627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKINZIE JONES

Provider Business Mailing Address
First Line	:	501 W JACK FROST WAY
Second Line	:
City	:	SARATOGA SPRINGS
State	:	UT
Zip	:	84045-5602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1410 N REDWOOD RD
Second Line	:
City	:	SARATOGA SPRINGS
State	:	UT
Zip	:	84045-7177
Country	:	US
Telephone Number	:	801-766-1426
Fax Number	:

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

Provider Enumeration Date	:	08/17/2020
Last Update Date	:	08/17/2020

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Directions to “ MCKINZIE JONES ” Practice Location

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