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NPI Code Detail

MEDICARE: MR. GREGORY THOMAS MYERS R.PH

MEDICARE: MR. GREGORY THOMAS MYERS R.PH
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
1183500000XPharmacist87-150377-1701UT

General Provider Information

NPI Number : 1568481273
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GREGORY THOMAS MYERS R.PH
Provider Business Mailing Address
First Line : 2000 S 900 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-3208
Country : US
Telephone Number : 801-464-7800
Fax Number : 801-464-7812
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 : 801-464-7812
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 07/08/2007

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