MEDICARE: DR. NICHOLAS DAVID SCHEURER 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	5794180-1701	UT
2	183500000X	Pharmacist	5794180	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5794180	OTHER	UT	LICENSE

General Provider Information

NPI Number	:	1689954398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS DAVID SCHEURER PHARMD.

Provider Business Mailing Address
First Line	:	7268 S BINGHAM JUNCTION BLVD STE B1
Second Line	:
City	:	MIDVALE
State	:	UT
Zip	:	84047-4860
Country	:	US
Telephone Number	:	855-779-3960
Fax Number	:

Provider Business Practice Location Address
First Line	:	7268 S BINGHAM JUNCTION BLVD STE B1
Second Line	:
City	:	MIDVALE
State	:	UT
Zip	:	84047-4860
Country	:	US
Telephone Number	:	855-779-3960
Fax Number	:

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

Provider Enumeration Date	:	08/25/2011
Last Update Date	:	10/10/2022

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