Provider Demographics
NPI:1275743015
Name:DURFEY, GARY L (RPH)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:L
Last Name:DURFEY
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 1:878 N 6400 W
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:UT
Mailing Address - Zip Code:84325-9728
Mailing Address - Country:US
Mailing Address - Phone:435-713-0445
Mailing Address - Fax:
Practice Address - Street 1:1550 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-1918
Practice Address - Country:US
Practice Address - Phone:435-753-0990
Practice Address - Fax:435-753-1969
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT273996-1701183500000X
IDP5295183500000X
WI13994183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist