IndividualActive
Ravindra Pathak, PHARMD, PHD, BCPS
NPI 1356347330 · Pharmacotherapy Pharmacist · Salt Lake City, UT
Provider details
- NPI number
- 1356347330
- Entity type
- Individual
- Primary specialty
- Pharmacotherapy PharmacistPharmacy Service Providers
- Credential
- PHARMD, PHD, BCPS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 11779 (NE)
Specialties & taxonomies
Pharmacy Service Providers
Pharmacy Service Providers
Pharmacy Service Providers
Pharmacy Service Providers
Practice location
500 Foothill Dr
Va Salt Lake City Hcs 119a
Salt Lake City, UT 84148-0001
Phone: (801) 582-1565
Approximate (ZIP-level) locationGet directions
Mailing address
1407 Emerson Ave
Salt Lake City, UT 84105-2607
Registry dates
- Enumerated
- 2005-06-23
- Last updated
- 2009-12-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.