Bryan Allred
Individual provider Active NPI Pharmacist · West Valley, UT
NPI 1073852018 · NPPES record last updated Feb 12, 2013
Key facts
- NPI
- 1073852018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 6729928-1701 (UT)
- Practice address
- 3725 W 4100 S
West Valley, UT 84120-5530 - Phone
- (801) 597-5650
- NPI assigned
- Feb 12, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6729928-1701 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Granger Pharmacy | Pharmacist | Current | Accepting new patients |
| Granger Pharmacy | Current | Accepting new patients |
Locations
3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6729928-1701 | UT | Yes |
Addresses
Primary practice location
3725 W 4100 S
West Valley, UT 84120-5530
Mailing address
2157 W 8770 S
West Jordan, UT 84088-9332
Phone (801) 597-5650
Other providers in West Valley, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2013. 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.