Active NPI
Brett Robert Boschetto, PHARMD
- Pharmacist
- Hyrum, UT
National Provider Identifier
1023731577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10071361-1701
- Practice address
- 790 E Main St
Hyrum, UT 84319-1408 - Phone
- (435) 245-3784
- Fax
- (435) 245-5306
- NPI assigned
- Sep 20, 2022
- Last updated
- Sep 20, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10071361-1701 | UT | Primary |
Addresses
Primary practice location
790 E Main St
Hyrum, UT 84319-1408
Mailing address
504 E 500 N
Providence, UT 84332-8801
Phone (909) 581-2506
Other practice location 1
50 N Highway 165
Providence, UT 84332-6700
Phone (435) 752-1111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10071361-1701 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conger Drug Inc | Current | Accepting new patients | |
| Maceys Inc | Past | Accepting new patients | |
| Maceys Inc | Past | Accepting new patients | |
| Conger Drug Inc | Past | Accepting new patients |
Locations
790 E Main St
Hyrum, UT 84319
Phone (435) 245-3784
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663632000000",
"number": "1023731577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 E 500 N",
"city": "PROVIDENCE",
"state": "UT",
"postal_code": "843328801",
"telephone_number": "909-581-2506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 E MAIN ST",
"city": "HYRUM",
"state": "UT",
"postal_code": "843191408",
"telephone_number": "435-245-3784",
"fax_number": "435-245-5306"
}
],
"practiceLocations": [
{
"address_1": "50 N Highway 165",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "UT",
"postal_code": "843326700",
"country_code": "US",
"telephone_number": "435-752-1111",
"fax_number": "435-752-7211",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOSCHETTO",
"first_name": "BRETT",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-20",
"last_updated": "2022-09-20",
"certification_date": "2022-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "10071361-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyrum, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.