Provider Demographics
NPI:1235850942
Name:PRICE, PAUL LOREN (RPH)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:LOREN
Last Name:PRICE
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 1:120 QUARTER CIR
Mailing Address - Street 2:
Mailing Address - City:NIBLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84321-6313
Mailing Address - Country:US
Mailing Address - Phone:435-232-9416
Mailing Address - Fax:
Practice Address - Street 1:44 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337-1624
Practice Address - Country:US
Practice Address - Phone:435-257-5249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT317054-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist