MEDICARE: ALISON ELAINE MARTIN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	067064	NY

General Provider Information

NPI Number	:	1730786864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON ELAINE MARTIN PHARMD

Provider Business Mailing Address
First Line	:	1111 E BRICKYARD RD APT 157
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-2972
Country	:	US
Telephone Number	:	585-455-8384
Fax Number	:

Provider Business Practice Location Address
First Line	:	2890 E COTTONWOOD PKWY
Second Line	:
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84121-7089
Country	:	US
Telephone Number	:	888-367-2119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2020
Last Update Date	:	12/04/2025

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