Provider Demographics
NPI:1174838395
Name:BERRETT, GOLDEN BENJAMIN (PHARMD, BCACP, BCADM)
Entity Type:Individual
Prefix:DR
First Name:GOLDEN
Middle Name:BENJAMIN
Last Name:BERRETT
Suffix:
Gender:M
Credentials:PHARMD, BCACP, BCADM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84701-1864
Mailing Address - Country:US
Mailing Address - Phone:435-896-6000
Mailing Address - Fax:435-896-1975
Practice Address - Street 1:508 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701-1864
Practice Address - Country:US
Practice Address - Phone:435-896-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT345828-8911183500000X
UT345828-1701183500000X, 1835P1200X
AZS0180711835P1200X
UT61513521835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy