Provider Demographics
NPI:1134412521
Name:DALTON, ROCHELLE KAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:KAY
Last Name:DALTON
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 1:3148 W 3500 S
Mailing Address - Street 2:ATTN: PHARMACY
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-3634
Mailing Address - Country:US
Mailing Address - Phone:801-963-2389
Mailing Address - Fax:801-963-2377
Practice Address - Street 1:3148 W 3500 S
Practice Address - Street 2:ATTN: PHARMACY
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-3634
Practice Address - Country:US
Practice Address - Phone:801-963-2389
Practice Address - Fax:801-963-2377
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5796706-89111835P0018X
UT5796706-17011835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist