Provider Demographics
NPI:1538709829
Name:LEWELLEN, AARON (PHARMD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:LEWELLEN
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 1:2353 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:UT
Mailing Address - Zip Code:84015-2454
Mailing Address - Country:US
Mailing Address - Phone:801-825-2262
Mailing Address - Fax:
Practice Address - Street 1:2353 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:UT
Practice Address - Zip Code:84015-2454
Practice Address - Country:US
Practice Address - Phone:801-825-2262
Practice Address - Fax:801-773-3989
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9683558-17011835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist