MEDICARE: DR. JEREMY CHADWICK MARSH PHARM. D.

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	5569302-1701	UT

General Provider Information

NPI Number	:	1295920312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEREMY CHADWICK MARSH PHARM. D.

Provider Business Mailing Address
First Line	:	2766 W 6680 S
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-1935
Country	:	US
Telephone Number	:	801-352-0090
Fax Number	:

Provider Business Practice Location Address
First Line	:	3955 W 3500 S
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-3307
Country	:	US
Telephone Number	:	801-352-0090
Fax Number	:

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

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	09/11/2007

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