Individual
MR. ROBERT MEDRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
955 E 1700 S, SALT LAKE CITY, UT 84105-3328
(801) 484-3213
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
145079-1701
UT
Other
Enumeration date
06/26/2006
Last updated
07/08/2007
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