Provider Demographics
NPI:1871733170
Name:MEYER, EUGENE L (RPH)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:L
Last Name:MEYER
Suffix:
Gender:M
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:PO BOX 360004
Mailing Address - Street 2:
Mailing Address - City:MONUMENT VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84536-0004
Mailing Address - Country:US
Mailing Address - Phone:435-727-3018
Mailing Address - Fax:435-727-3082
Practice Address - Street 1:EAST HWY #262
Practice Address - Street 2:
Practice Address - City:MONTEZUMA CREEK
Practice Address - State:UT
Practice Address - Zip Code:84534
Practice Address - Country:US
Practice Address - Phone:435-727-3018
Practice Address - Fax:435-727-3082
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4878828-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist