Ryan Steadman
Individual provider Active NPI Pharmacist · Enterprise, UT
NPI 1356574388 · NPPES record last updated Aug 25, 2009
Key facts
- NPI
- 1356574388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 6375955 (UT)
- Practice address
- 660 East Main Street
#A
Enterprise, UT 84725 - Phone
- (435) 878-2760
- NPI assigned
- Aug 25, 2009
- 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 |
|---|---|---|---|
| 6375955 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KTM Health Care Inc | Past | Accepting new patients | |
| KTM Health Care Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6375955 | UT | Yes |
Addresses
Primary practice location
660 East Main Street
#A
Enterprise, UT 84725
Mailing address
660 East Main Street #a
Enterprise, UT 84725
Other providers in Enterprise, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2009. 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.