Provider Demographics
NPI:1912454448
Name:SEAMONS, TODD J (PHARMD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:J
Last Name:SEAMONS
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 1:1518 KENTUCKY DERBY WAY
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037
Mailing Address - Country:US
Mailing Address - Phone:801-408-1122
Mailing Address - Fax:801-408-5172
Practice Address - Street 1:8TH AVE & C ST
Practice Address - Street 2:OUTPATIENT PHARMACY
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84143
Practice Address - Country:US
Practice Address - Phone:801-408-1122
Practice Address - Fax:801-408-5172
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6297278-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist