Healthcare Provider Details

I. General information

NPI: 1841510096
Provider Name (Legal Business Name): MELISSA FOWLER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10305 S 1300 E
SANDY UT
84094-4681
US

IV. Provider business mailing address

10305 S 1300 E
SANDY UT
84094-4681
US

V. Phone/Fax

Practice location:
  • Phone: 801-572-1398
  • Fax:
Mailing address:
  • Phone: 801-572-1395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5042929-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: