Healthcare Provider Details

I. General information

NPI: 1831817782
Provider Name (Legal Business Name): ALISON BLAIR DOANE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 08/17/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6272 S HIGHLAND DR
MURRAY UT
84121-2126
US

IV. Provider business mailing address

353 N CENTER ST
SALT LAKE CITY UT
84103-1624
US

V. Phone/Fax

Practice location:
  • Phone: 810-449-4061
  • Fax:
Mailing address:
  • Phone: 810-449-4061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number12912683-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: