Jordan Earl, RPH
Individual provider Active NPI Pharmacist · Highland, UT
NPI 1336744309 · NPPES record last updated Nov 30, 2020
Key facts
- NPI
- 1336744309
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 6901967-1701 (UT)
- Practice address
- 5326 W 11000 N
Highland, UT 84003-9544 - Phone
- (801) 763-9786
- NPI assigned
- Nov 30, 2020
- 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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6901967-1701 | UT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6901967-1701 | UT | Yes |
Addresses
Primary practice location
5326 W 11000 N
Highland, UT 84003-9544
Mailing address
597 W 900 N
American Fork, UT 84003-5120
Other providers in Highland, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 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.