Provider Demographics
NPI:1396067112
Name:TOPOLOVEC, KENNETH PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:PAUL
Last Name:TOPOLOVEC
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 1:3900 N 2000 W
Mailing Address - Street 2:
Mailing Address - City:HELPER
Mailing Address - State:UT
Mailing Address - Zip Code:84526-2218
Mailing Address - Country:US
Mailing Address - Phone:435-472-3028
Mailing Address - Fax:
Practice Address - Street 1:610 W PRICE RIVER DR
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-2839
Practice Address - Country:US
Practice Address - Phone:435-637-0806
Practice Address - Fax:435-637-6153
Is Sole Proprietor?:No
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT146534-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist