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NPI Code Detail

MEDICARE: UNIVERSITY OF UTAH PHARMACIES

MEDICARE: UNIVERSITY OF UTAH PHARMACIES
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
1333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1744OTHERUTNCPDP CHAIN CODE

General Provider Information

NPI Number : 1164695318
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OF UTAH PHARMACIES
Provider Business Mailing Address
First Line : PO BOX 841208
Second Line :
City : LOS ANGELES
State : CA
Zip : 90084-1208
Country : US
Telephone Number : 801-587-6334
Fax Number : 801-587-2996
Provider Business Practice Location Address
First Line : 250 E 200 S STE 1325
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-2953
Country : US
Telephone Number : 801-587-6334
Fax Number : 801-587-2996
Authorized Official
Title or Position : PHARMACY BUSINESS OPERATIONS MGR
Name : KELLEE K HOWELL
Credential : CPHT
Telephone Number : 801-587-6334
Provider Enumeration Date : 04/09/2008
Last Update Date : 05/07/2021

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Directions to “UNIVERSITY OF UTAH PHARMACIES ” Practice Location

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