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NPI Code Detail

MEDICARE: MR. GREGG R LUKE R.PH.

MEDICARE:  MR. GREGG R LUKE  R.PH.
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
1183500000XPharmacist152169-1701UT

General Provider Information

NPI Number : 1922024959
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GREGG R LUKE R.PH.
Provider Business Mailing Address
First Line : 5331 W 2400 S
Second Line :
City : MENDON
State : UT
Zip : 84325-9752
Country : US
Telephone Number : 435-755-9553
Fax Number :
Provider Business Practice Location Address
First Line : 550 E 1400 N STE K
Second Line :
City : NORTH LOGAN
State : UT
Zip : 84341-2450
Country : US
Telephone Number : 435-755-8424
Fax Number : 453-755-8436
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 09/12/2008

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Directions to “ MR. GREGG R LUKE R.PH.” Practice Location

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