Wesley Crouch, PHARM.D
Individual provider Active NPI Pharmacist · Ephraim, UT
NPI 1043399520 · NPPES record last updated Nov 23, 2020
Key facts
- NPI
- 1043399520
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5260544-1701 (UT)
- Practice address
- 777 N Main St
Ephraim, UT 84627-1165 - Phone
- (435) 283-8194
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5260544-1701 | UT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5260544-1701 | UT | Yes |
Addresses
Primary practice location
777 N Main St
Ephraim, UT 84627-1165
Mailing address
79 W 100 S
Ephraim, UT 84627-1332
Phone (435) 813-2404
Other practice location 1
1100 S Medical Dr
MT Pleasant, UT 84647-2222
Phone (435) 462-4159
Other practice location 2
8th Ave & C Street
Salt Lake City, UT 84101
Phone (801) 408-4068
Other providers in Ephraim, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 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.