MEDICARE: STEPHANIE COOK

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	1205235736	UT

General Provider Information

NPI Number	:	1205235736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE COOK

Provider Business Mailing Address
First Line	:	5710 W 7800 S
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84081-5436
Country	:	US
Telephone Number	:	801-545-3480
Fax Number	:

Provider Business Practice Location Address
First Line	:	5710 W 7800 S
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84081-5436
Country	:	US
Telephone Number	:	801-545-3480
Fax Number	:

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

Provider Enumeration Date	:	08/20/2014
Last Update Date	:	05/19/2026

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Directions to “ STEPHANIE COOK ” Practice Location

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