Provider Demographics
NPI:1326329475
Name:SLIMAK, PATRICK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:SLIMAK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5492 PROSPERO LN
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-6670
Mailing Address - Country:US
Mailing Address - Phone:352-359-6243
Mailing Address - Fax:
Practice Address - Street 1:5627 W 13400 S
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84096-7204
Practice Address - Country:US
Practice Address - Phone:801-307-1909
Practice Address - Fax:801-307-1939
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT62846091701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist