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Individual

REZA MOHAMMAD SAFARPOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
4111 JUPITER DR, SALT LAKE CITY, UT 84124-3341
(801) 272-0550
Mailing address
4111 JUPITER DR, SALT LAKE CITY, UT 84124-3341
(801) 272-0550

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2797369-1701
UT
183500000X
Pharmacist
PH00022047
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2797369
STATE LICENSE NUMBER
UT
01
PH00022047
STATE LICENSE NUMBER
WA
Enumeration date
03/10/2006
Last updated
12/13/2010
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