Provider Demographics
NPI:1710293717
Name:HOFFMAN, CARL THOMAS III (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:THOMAS
Last Name:HOFFMAN
Suffix:III
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 1:1320 E 200 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2604
Mailing Address - Country:US
Mailing Address - Phone:801-582-7624
Mailing Address - Fax:801-582-7633
Practice Address - Street 1:1320 E 200 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2604
Practice Address - Country:US
Practice Address - Phone:801-582-7624
Practice Address - Fax:801-582-7633
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT374884-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist