BRADLEY BROUILLETTE (NPI# 1578014924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578014924 |
Entity Type | Individual |
Full Name | BRADLEY BROUILLETTE |
Credential | RPH |
Practice Address |
5201 S Intermountain Dr Murray UT 84107-6024 |
Mailing Address |
436 S 1200 E Salt Lake City UT 84102-3106 |
Practice Telephone | 8012904202 |
Mailing Telephone | 4356913103 |
Enumeration Date | 2016-10-20 |
Last Update Date | 2016-10-20 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
5867667-1701 | UT | Pharmacy Service Providers |
Street Address |
5201 S INTERMOUNTAIN DR |
City | MURRAY |
State | UT |
Zip Code | 84107-6024 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447360078 | Costco Wholesale Corporation | Pharmacy | 5201 S Intermountain Dr, Murray, UT 84107 | 2006-08-30 |
1003427543 | Preston D Warren | Pharmacist | 5201 S Intermountain Dr, Murray, UT 84107-6024 | 2020-08-10 |
1053952556 | Elizabeth S Papenfuss | Pharmacist | 5201 S Intermountain Dr, Murray, UT 84107-6024 | 2019-10-05 |
1033611975 | Hyriam James Fleming | Pharmacist | 5201 S Intermountain Dr, Murray, UT 84107-6024 | 2018-03-07 |
1154715779 | Costco Wholesale Corporation | Hearing Aid Equipment | 5201 S Intermountain Dr, Murray, UT 84107-6024 | 2015-03-20 |
1326439530 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 5201 S Intermountain Dr, Murray, UT 84107-6024 | 2015-02-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
Find all providers in zip 84107 |
Taxonomy Code | 1835P2201X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Ambulatory Care |
A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831703198 | Benjamin Dean Jolley | Pharmacist | 1702 S 1100 E, Salt Lake City, UT 84105-3424 | 2020-09-03 |
1669091781 | Patrick Welch | Pharmacist | 4393 S Riverboat Rd, Salt Lake City, UT 84123-2503 | 2020-04-09 |
1487295952 | Jimmy Nguyen | Pharmacist | 828 S 900 W, Salt Lake City, UT 84104-1455 | 2019-10-04 |
1518518711 | Brad K Stocking | Pharmacist | 20 N Bluff St, Saint George, UT 84770-3334 | 2019-09-27 |
1083175053 | Julie Mills Haymore | Pharmacist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2019-03-30 |
1770054777 | Bradly Dean Winter | Pharmacist | 2075 University Park Blvd, Layton, UT 84041-1611 | 2018-12-17 |
1487133542 | Heidi Pigott | Pharmacist | 5541 W 13400 S, Riverton, UT 84096-5640 | 2018-08-09 |
1194258657 | Nicole Lopez | Pharmacist | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2017-04-11 |
1194268466 | Vanessa B Nielsen | Pharmacist | 615 S Arapeen Dr Ste 100, Salt Lake City, UT 84108-1239 | 2016-11-18 |
1053785386 | Samuel Chase Warner | Pharmacist | 1638 S 900 E, Salt Lake City, UT 84105-2366 | 2015-11-24 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.