Provider Demographics
NPI:1811940075
Name:TAYLOR, LEE E (RPH)
Entity type:Individual
Prefix:MS
First Name:LEE
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 S HIDDEN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:HEBER
Mailing Address - State:UT
Mailing Address - Zip Code:84032
Mailing Address - Country:US
Mailing Address - Phone:435-658-9280
Mailing Address - Fax:435-658-9290
Practice Address - Street 1:1743 REDSTONE CENTER DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-7600
Practice Address - Country:US
Practice Address - Phone:435-658-9280
Practice Address - Fax:435-658-9290
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT132737-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist