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NPI Code Detail

MEDICARE: COLTON KURT WASHBURN RPH

MEDICARE:   COLTON KURT WASHBURN  RPH
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
1183500000XPharmacist9339082-1701UT

General Provider Information

NPI Number : 1801466750
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLTON KURT WASHBURN RPH
Provider Business Mailing Address
First Line : 3363 W BEAR RIVER RD
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-5001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1962 W 1800 N
Second Line :
City : CLINTON
State : UT
Zip : 84015-8328
Country : US
Telephone Number : 801-614-1347
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2021
Last Update Date : 07/01/2021

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Directions to “ COLTON KURT WASHBURN RPH” Practice Location

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