Penny Kristine Fergus, PHARMD, RPH
Individual provider Active NPI Pharmacist · Hill Afb, UT
NPI 1376714030 · NPPES record last updated Mar 20, 2008
Key facts
- NPI
- 1376714030
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH-0010514 (OR)
- Practice address
- 7321 11TH St BLDG 570
Hill Afb, UT 84056-5012 - Phone
- (801) 777-0419
- Fax
- (801) 586-9530
- NPI assigned
- Mar 20, 2008
- Sex
- Female
- Sole proprietor
- No
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0010514 | OR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-0010514 | OR | Yes |
Addresses
Primary practice location
7321 11TH St BLDG 570
Hill Afb, UT 84056-5012
Mailing address
7321 11TH St BLDG 570
Hill Afb, UT 84056-5012
Phone (801) 777-0419
Other providers in Hill Afb, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2008. 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.