Provider Demographics
NPI:1790447944
Name:FINKENTHAL, HAZAEL SHERARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:HAZAEL
Middle Name:SHERARD
Last Name:FINKENTHAL
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 1:4048 W SHINNEROCK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-6017
Mailing Address - Country:US
Mailing Address - Phone:385-539-0500
Mailing Address - Fax:
Practice Address - Street 1:3590 W SOUTH JORDAN PKWY
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8916
Practice Address - Country:US
Practice Address - Phone:801-601-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10280031-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist