MEDICARE: JEFFREY FOWERS PHARMD

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	7426510-1701	UT

General Provider Information

NPI Number	:	1578279048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY FOWERS PHARMD

Provider Business Mailing Address
First Line	:	2645 N WASHINGTON BLVD
Second Line	:
City	:	NORTH OGDEN
State	:	UT
Zip	:	84414-2240
Country	:	US
Telephone Number	:	801-782-6116
Fax Number	:	801-782-7222

Provider Business Practice Location Address
First Line	:	2645 N WASHINGTON BLVD
Second Line	:
City	:	NORTH OGDEN
State	:	UT
Zip	:	84414-2240
Country	:	US
Telephone Number	:	801-782-6116
Fax Number	:	801-782-7222

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

Provider Enumeration Date	:	01/26/2023
Last Update Date	:	01/26/2023

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Directions to “ JEFFREY FOWERS PHARMD” Practice Location

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