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General NPI Number Information
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NPI Number | 1902407240
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Entity Type | Individual
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Provider Name | DAVID ANDREW FEOLO PHARM D
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Gender | Male
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 845 E 4500 S
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-3049
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Country | US
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Telephone | 801-261-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 561 E 900 S
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City | SALT LAKE CITY
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State | UT
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Zip | 84105-1126
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Country | US
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Telephone | 801-556-7951
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 9816679-1701
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License Number State | UT
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