William Lance Andersen, RPH
Individual provider Active NPI Pharmacist · Riverton, UT
NPI 1659972248 · NPPES record last updated Nov 12, 2020
Key facts
- NPI
- 1659972248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 132813-1701 (UT)
- Practice address
- 1202 W 12600 W
Riverton, UT 84065 - Phone
- (801) 999-2795
- Fax
- (801) 999-2796
- NPI assigned
- Nov 2, 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 |
|---|---|---|---|
| 132813-1701 | UT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 132813-1701 | UT | Yes |
Addresses
Primary practice location
1202 W 12600 W
Riverton, UT 84065
Mailing address
10809 S 2420 W
South Jordan, UT 84095-2633
Phone (801) 999-2795
Other providers in Riverton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 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.