Travis Snow, PHARMD
Individual provider Active NPI Pharmacist · Santa Clara, UT
NPI 1124533377 · NPPES record last updated Aug 10, 2021
Key facts
- NPI
- 1124533377
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 7066416-1701 (UT)
- Practice address
- 1100 Canyon View Dr Ste C
Santa Clara, UT 84765-5672 - Phone
- (435) 703-9680
- NPI assigned
- Dec 11, 2017
- Sex
- Male
- Sole proprietor
- Yes
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7066416-1701 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fusion Pharmacy LLC | Current | Accepting new patients | |
| Fusion Specialty Pharmacy Inc | Past | Accepting new patients |
Locations
1100 Canyon View Dr
Ste C
Santa Clara, UT 84765
Phone (435) 703-9680
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7066416-1701 | UT | Yes |
Addresses
Primary practice location
1100 Canyon View Dr Ste C
Santa Clara, UT 84765-5672
Mailing address
1100 Canyon View Dr Ste C
Santa Clara, UT 84765-5672
Phone (435) 703-9680
Other providers in Santa Clara, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2021. 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.