Provider Demographics
NPI:1114040094
Name:MCOMBER, GAIL COOK (RPH)
Entity type:Individual
Prefix:MR
First Name:GAIL
Middle Name:COOK
Last Name:MCOMBER
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 1:1115 SAPHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3734
Mailing Address - Country:US
Mailing Address - Phone:801-571-9435
Mailing Address - Fax:
Practice Address - Street 1:3835 W 5400 S
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84118-3548
Practice Address - Country:US
Practice Address - Phone:801-966-1488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1442881701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist