Healthcare Provider Details

I. General information

NPI: 1568298719
Provider Name (Legal Business Name): SONDRA DONALD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 GRAND AVE
AMES IA
50010-4604
US

IV. Provider business mailing address

3105 GRAND AVE
AMES IA
50010-4604
US

V. Phone/Fax

Practice location:
  • Phone: 515-441-8124
  • Fax: 515-441-8129
Mailing address:
  • Phone: 515-441-8124
  • Fax: 515-441-8129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19317
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number19317
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: