MEDICARE: SIUEA PETE KUPU

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	17350-1701	UT

General Provider Information

NPI Number	:	1629415559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIUEA PETE KUPU

Provider Business Mailing Address
First Line	:	3571 S HIGHLANDER ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84128-2317
Country	:	US
Telephone Number	:	801-891-1768
Fax Number	:

Provider Business Practice Location Address
First Line	:	3571 S HIGHLANDER ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84128-2317
Country	:	US
Telephone Number	:	801-891-1768
Fax Number	:

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

Provider Enumeration Date	:	06/01/2013
Last Update Date	:	06/01/2013

Similar Medicare Providers

1225197379 — MICHELLE M DAHLE FNP
Practice Location Address:

3534 S 6000 W
SALT LAKE CITY, UT
84128-2610

Practice Phone: 801-969-6264
Practice Fax: 801-969-6333

1679840334 — DAVID LEE DEHERRERA RPH
Practice Location Address:

5630 W 4100 S
SALT LAKE CITY, UT
84128-4338

Practice Phone: 801-840-5155
Practice Fax:

1770908048 — VELVET STAUB LCSW
Practice Location Address:

5698 W GLEN EAGLE DR
SALT LAKE CITY, UT
84128-4013

Practice Phone: 801-969-4181
Practice Fax:

1356817167 — FAMILY CARE LLC
Practice Location Address:

2569 S BEAGLEY CIR
SALT LAKE CITY, UT
84128-5539

Practice Phone: 385-246-3996
Practice Fax:

1760287338 — JESUS LOPEZ AGUILAR
Practice Location Address:

6416 W NEWTON FARM DR
SALT LAKE CITY, UT
84128-2408

Practice Phone: 213-369-9006
Practice Fax:

1245290691 — MR. RICK HACKFORD ATC
Practice Location Address:

6270 W 3705 S
WEST VALLEY CITY, UT
84128-2560

Practice Phone: 801-832-2341
Practice Fax:

Directions to “ SIUEA PETE KUPU ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.