Provider Demographics
NPI:1548095631
Name:GILLINS, DAVID AHLMER (PHARMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:AHLMER
Last Name:GILLINS
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 1:3288 W 6735 S
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-6921
Mailing Address - Country:US
Mailing Address - Phone:801-721-7292
Mailing Address - Fax:
Practice Address - Street 1:5171 S COTTONWOOD ST STE 350
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5733
Practice Address - Country:US
Practice Address - Phone:801-507-2804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8904787-17011835I0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835I0206XPharmacy Service ProvidersPharmacistInfectious Diseases