Active NPI
Myrle Willmore, RPH
- Pharmacist
- Logan, UT
National Provider Identifier
1275747768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 142251-1701
- Practice address
- 500 E 1400 N
Logan, UT 84341-2465 - Phone
- (435) 716-5158
- Fax
- (435) 753-7636
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 142251-1701 | UT | Primary |
Addresses
Primary practice location
500 E 1400 N
Logan, UT 84341-2465
Mailing address
29 Shadow Mountain Dr
Logan, UT 84321-6757
Phone (435) 787-8474
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 142251-1701 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275747768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 SHADOW MOUNTAIN DR",
"city": "LOGAN",
"state": "UT",
"postal_code": "843216757",
"telephone_number": "435-787-8474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E 1400 N",
"city": "LOGAN",
"state": "UT",
"postal_code": "843412465",
"telephone_number": "435-716-5158",
"fax_number": "435-753-7636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLMORE",
"first_name": "MYRLE",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "142251-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.