Kohlers Food Stores Phamacy
Organization Active NPI Pharmacist · Highland, UT
NPI 1003894973 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1003894973
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- 274777-1703 (UT)
- Legal business name
- KOHLERS FOOD STORES PHAMACY
- Practice address
- 5353 W 11000 N
Highland, UT 84003-9403 - Phone
- (801) 756-2250
- NPI assigned
- Jan 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Charles Richard Willie, PHARMACIST
- Title
- Head Pharmacist
- Phone
- (801) 756-2250
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 274777-1703 | UT | Yes |
Addresses
Primary practice location
5353 W 11000 N
Highland, UT 84003-9403
Mailing address
5353 W 11000 N
Highland, UT 84003-9403
Phone (801) 756-2250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870309253012 | Medicaid | UT |
Other providers in Highland, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.