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NPI Code Detail

MEDICARE: MAHNAZ PAYVARMEHR RPH

MEDICARE:   MAHNAZ  PAYVARMEHR  RPH
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
1183500000XPharmacist132057-1701UT

General Provider Information

NPI Number : 1407200652
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAHNAZ PAYVARMEHR RPH
Provider Business Mailing Address
First Line : 3192 S YOSEMITE DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-2342
Country : US
Telephone Number : 801-557-0589
Fax Number :
Provider Business Practice Location Address
First Line : 2000 S 900 E
Second Line :
City : SLC
State : UT
Zip : 84105-3208
Country : US
Telephone Number : 801-464-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2016
Last Update Date : 04/13/2016

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Directions to “ MAHNAZ PAYVARMEHR RPH” Practice Location

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