Active NPI
Seth William Poulson
- Pharmacist
- Salt Lake City, UT
National Provider Identifier
1568063303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7792466-1701
- Practice address
- 2705 E Parleys Way
Salt Lake City, UT 84109-1619 - Phone
- (385) 313-3949
- NPI assigned
- Nov 6, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 7792466-1701 | UT | Primary |
Addresses
Primary practice location
2705 E Parleys Way
Salt Lake City, UT 84109-1619
Mailing address
103 Willow St
Grantsville, UT 84029-9479
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7792466-1701 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604620800000",
"number": "1568063303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 WILLOW ST",
"city": "GRANTSVILLE",
"state": "UT",
"postal_code": "840299479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 E PARLEYS WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841091619",
"telephone_number": "385-313-3949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULSON",
"first_name": "SETH",
"middle_name": "WILLIAM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-06",
"last_updated": "2020-11-06",
"certification_date": "2020-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "7792466-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.