# FUSION SPECIALTY PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fusion Specialty Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508104712
- **Authorized official:** KOBY TAYLOR PHARMD (PRESIDENT)
- **Authorized official phone:** (435) 703-9680

## Contact information

- **Practice address:** 1100 CANYON VIEW DR STE C, SANTA CLARA, UT 84765-5672
- **Practice address phone:** (435) 703-9680
- **Practice address fax:** (855) 853-3465
- **Mailing address:** 1100 CANYON VIEW DR, STE C, SANTA CLARA, UT 84765-5671
- **Mailing address phone:** (435) 703-9680
- **Mailing address fax:** (855) 853-3465

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 033401 | NY | — |
| 3336C0003X | Community/Retail Pharmacy | 1260 | AK | Yes |
| 3336C0003X | Community/Retail Pharmacy | 2013016261 | MO | — |
| 3336C0003X | Community/Retail Pharmacy | 21457MS | ID | — |
| 3336C0003X | Community/Retail Pharmacy | 22-13015 | KS | — |
| 3336C0003X | Community/Retail Pharmacy | 28RO00142300 | NJ | — |
| 3336C0003X | Community/Retail Pharmacy | NRP.022647900-03 | OH | — |
| 3336C0003X | Community/Retail Pharmacy | OSP.0006181 | CO | — |
| 3336C0003X | Community/Retail Pharmacy | PH000039111 | NM | — |
| 3336C0003X | Community/Retail Pharmacy | PH02951 | NV | — |
| 3336C0003X | Community/Retail Pharmacy | PH30592 | FL | — |
| 3336C0003X | Community/Retail Pharmacy | PHA-MOP-LIC-21763 | MT | — |
| 3336C0003X | Community/Retail Pharmacy | PHNR001096 | GA | — |
| 3336C0003X | Community/Retail Pharmacy | PMP-966 | HI | — |
| 3336C0003X | Community/Retail Pharmacy | RP-0002986-CS | OR | — |

## Other

- **Enumeration date:** 01/23/2013
- **Last updated:** 02/05/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2138783 | PK | — |