MEDICARE: SYDNEY PICKETT

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	11873638-1701	UT

General Provider Information

NPI Number	:	1922954114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY PICKETT

Provider Business Mailing Address
First Line	:	201 E SOUTH TEMPLE APT 135
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84111-1294
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 W 2100 S
Second Line	:
City	:	SOUTH SALT LAKE
State	:	UT
Zip	:	84115-1830
Country	:	US
Telephone Number	:	385-212-2934
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ SYDNEY PICKETT ” Practice Location

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