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General NPI Number Information
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NPI Number | 1992112221
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Entity Type | Individual
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Provider Name | JOSHUA ALLDREDGE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2014
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Last Update Date | 07/18/2014
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Provider Practice Location Address
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Address Line | 200 N MARKET PLACE DR
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City | CENTERVILLE
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State | UT
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Zip | 84014-1752
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Country | US
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Telephone | 801-292-1546
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Fax |
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Provider Business Mailing Address
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Address Line | 120 E 550 N APT 1
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City | BOUNTIFUL
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State | UT
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Zip | 84010-6064
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Country | US
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Telephone | 801-694-1351
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6296131
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License Number State | UT
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