Provider Demographics
NPI:1659409159
Name:BESTENELHNER, DAVID ANDREW (PHARM D)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:BESTENELHNER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 W 550 N
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-8265
Mailing Address - Country:US
Mailing Address - Phone:435-789-7959
Mailing Address - Fax:
Practice Address - Street 1:151 W 200 N
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-1907
Practice Address - Country:US
Practice Address - Phone:435-789-3342
Practice Address - Fax:435-781-6881
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT344930-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist