Provider Demographics
NPI:1427179605
Name:OBORNY, TRICIA L (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:L
Last Name:OBORNY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 HILLSIDE VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3363
Mailing Address - Country:US
Mailing Address - Phone:307-399-1288
Mailing Address - Fax:
Practice Address - Street 1:8TH AVENUE AND C ST
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84143-0001
Practice Address - Country:US
Practice Address - Phone:801-408-4068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5672910-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist