Healthcare Provider Details

I. General information

NPI: 1164195590
Provider Name (Legal Business Name): JOSHUA ARTHUR MCDONALD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 N MAIN ST
BOUNTIFUL UT
84010-6046
US

IV. Provider business mailing address

360 S 400 W APT 237
SALT LAKE CITY UT
84101-1971
US

V. Phone/Fax

Practice location:
  • Phone: 801-397-6400
  • Fax:
Mailing address:
  • Phone: 319-981-0384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number11327246-0701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: