MEDICARE: MS. LINDSAY BETH GASCH PHARM. D.

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	3186	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14215-040	OTHER	WI	STATE PHARMACY LICENSE
2	WY3186	OTHER	WY	STATE PHARMACY LICENSE

General Provider Information

NPI Number	:	1821122854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDSAY BETH GASCH PHARM. D.

Provider Business Mailing Address
First Line	:	1400 S 600 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-2023
Country	:	US
Telephone Number	:	262-442-9282
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 S 600 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-2023
Country	:	US
Telephone Number	:	262-442-9282
Fax Number	:

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	08/29/2011

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