Provider Demographics
NPI:1225143431
Name:HAMADA, LESTER CRAIG (RPH)
Entity Type:Individual
Prefix:MR
First Name:LESTER
Middle Name:CRAIG
Last Name:HAMADA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 E 12500 S
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9160
Mailing Address - Country:US
Mailing Address - Phone:801-553-6332
Mailing Address - Fax:801-961-6324
Practice Address - Street 1:221 CHARLES LINDBERGH DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84116-2811
Practice Address - Country:US
Practice Address - Phone:801-961-6219
Practice Address - Fax:801-961-6324
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT144172-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist