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Individual

BUCK EDWARD STANFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH, MBA

Contact information

Practice address
4393 S RIVERBOAT RD, SALT LAKE CITY, UT 84123-2503
(801) 284-1005
Mailing address
4393 S RIVERBOAT RD, SALT LAKE CITY, UT 84123-2503
(801) 284-1005

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
26019282A
IN
183500000X
Pharmacist
Primary
88598291701
UT
1835P2201X
Ambulatory Care Pharmacist
88598291701
UT

Other

Enumeration date
10/21/2017
Last updated
10/21/2017
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