Taurean Stewart
Individual provider Active NPI Pharmacist · Hyrum, UT
NPI 1265168595 · NPPES record last updated Jul 28, 2022
Key facts
- NPI
- 1265168595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 6509794-1702 (UT)
- Practice address
- 790 E Main St
Hyrum, UT 84319-1408 - Phone
- (435) 245-3784
- NPI assigned
- Jul 28, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 6509794-1702 | UT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 6509794-1702 | UT | Yes |
Addresses
Primary practice location
790 E Main St
Hyrum, UT 84319-1408
Mailing address
790 E Main St
Hyrum, UT 84319-1408
Phone (435) 245-3784
Other providers in Hyrum, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2022. 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.