MEDICARE: JOHN B LOERTSCHER 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
1	183500000X	Pharmacist	150789	UT

General Provider Information

NPI Number	:	1861120693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN B LOERTSCHER RPH

Provider Business Mailing Address
First Line	:	2238 W TEMPLE VIEW LN
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84095-8926
Country	:	US
Telephone Number	:	801-971-2487
Fax Number	:

Provider Business Practice Location Address
First Line	:	11453 S PARKWAY PLAZA DR
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84095-5614
Country	:	US
Telephone Number	:	801-495-5353
Fax Number	:

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

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

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