| Doctor Name: | MR. GLENN THOMAS CARMODY |
| NPI Number: | 1033252564 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPH |
| License Number: | 3082638-1701 |
| Business Practice Address: | 1152 W 2240 S Ste E West Valley City, UT - 841197245 |
| Business Phone Number: | 8014853344 |
| Business Fax Number: | 8014851982 |
| Mailing Address: | 14291 Stone Fly Dr, BLUFFDALE |
| State: | UT |
| Postal Code: | 840655605 |
| Phone Number: | 8014462122 |
| Fax Number: | 8014851982 |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835N0905X |
| License Number: | 3082638-1701 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Nuclear |
| Taxonomy Definition: | A licensed pharmacist who has demonstrated specialized knowledge and skill in procurement, compounding, quality control testing, dispensing, distribution, and monitoring of radiopharmaceuticals. |