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NPI Code Detail

MEDICARE: DAVID ANDREW FEOLO PHARM D

MEDICARE:   DAVID ANDREW FEOLO  PHARM D
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist9816679-1701UT

General Provider Information

NPI Number : 1902407240
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID ANDREW FEOLO PHARM D
Provider Business Mailing Address
First Line : 561 E 900 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-1126
Country : US
Telephone Number : 801-556-7951
Fax Number :
Provider Business Practice Location Address
First Line : 845 E 4500 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84107-3049
Country : US
Telephone Number : 801-261-8787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2020
Last Update Date : 11/03/2020

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Directions to “ DAVID ANDREW FEOLO PHARM D” Practice Location

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