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NPI Code Detail

MEDICARE: HEARTLAND PHARMACY - UTAH

MEDICARE: HEARTLAND PHARMACY - UTAH
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1174131916
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTLAND PHARMACY - UTAH
Provider Business Mailing Address
First Line : 1790 SABIN DR
Second Line :
City : AMMON
State : ID
Zip : 83406-6747
Country : US
Telephone Number : 208-497-3575
Fax Number :
Provider Business Practice Location Address
First Line : 160 CUTLER DR
Second Line :
City : NORTH SALT LAKE
State : UT
Zip : 84054-2966
Country : US
Telephone Number : 208-497-3575
Fax Number :
Authorized Official
Title or Position : CEO PRESIDENT
Name : REECE CHRISTENSEN
Credential :
Telephone Number : 208-497-3575
Provider Enumeration Date : 07/17/2020
Last Update Date : 07/17/2020

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Directions to “HEARTLAND PHARMACY - UTAH ” Practice Location

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