Individual
KELLY W MAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2400 N WASHINGTON BLVD, NORTH OGDEN, UT 84414-7233
(801) 786-7600
(801) 786-7610
Mailing address
2400 N WASHINGTON BLVD, NORTH OGDEN, UT 84414-7233
(801) 786-7600
(801) 786-7610
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
286410-1701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
286410-1701
DOPL PHARMACIST
UT
01
—
286410-8911
DOPL PHARMACIST CONTROLLED SUBSTANCE
UT
Enumeration date
05/12/2010
Last updated
05/12/2010
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