Organization
FUSION SPECIALTY PHARMACY INC
Active
Other names
Fusion Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KOBY TAYLOR PHARMD (PRESIDENT)
(435) 703-9680
Entity
Organization
Contact information
Practice address
1100 CANYON VIEW DR STE C, SANTA CLARA, UT 84765-5672
(435) 703-9680
(855) 853-3465
Mailing address
1100 CANYON VIEW DR, STE C, SANTA CLARA, UT 84765-5671
(435) 703-9680
(855) 853-3465
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
033401
NY
3336C0003X
Community/Retail Pharmacy
Primary
1260
AK
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
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138783
PK
—
Enumeration date
01/23/2013
Last updated
02/05/2025
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