MEDICARE: CAMERON W JOHNSON 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	6725269-1701	UT

General Provider Information

NPI Number	:	1639064702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON W JOHNSON PHARMD

Provider Business Mailing Address
First Line	:	836 W 25 N
Second Line	:
City	:	CLEARFIELD
State	:	UT
Zip	:	84015-9208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	890 S MAIN ST
Second Line	:
City	:	HEBER CITY
State	:	UT
Zip	:	84032-2463
Country	:	US
Telephone Number	:	435-654-0414
Fax Number	:

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

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	06/10/2025

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