Provider Demographics
NPI:1992351886
Name:BRINKERHOFF, COLE (RPH)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:BRINKERHOFF
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 1:6205 W 4700 S
Mailing Address - Street 2:
Mailing Address - City:HOOPER
Mailing Address - State:UT
Mailing Address - Zip Code:84315-9749
Mailing Address - Country:US
Mailing Address - Phone:385-216-8078
Mailing Address - Fax:
Practice Address - Street 1:217 N 2000 W
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:UT
Practice Address - Zip Code:84015-8026
Practice Address - Country:US
Practice Address - Phone:385-383-3040
Practice Address - Fax:385-383-3045
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT152119-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist