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NPI Code Detail

MEDICARE: DR. LAURA SHANE-MCWHORTER PHARMD

MEDICARE: DR. LAURA SHANE-MCWHORTER 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
11835P1200XPharmacotherapy Pharmacist149291-1701UT

General Provider Information

NPI Number : 1982694964
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA SHANE-MCWHORTER PHARMD
Provider Business Mailing Address
First Line : 30 S 2000 E
Second Line : ROOM 260 UNIVERSITY OF UTAH COLLEGE OF PHARMACY
City : SALT LAKE CITY
State : UT
Zip : 84112-5820
Country : US
Telephone Number : 801-585-9564
Fax Number :
Provider Business Practice Location Address
First Line : 461 S 400 E
Second Line : CENTRAL CITY CHC
City : SALT LAKE CITY
State : UT
Zip : 84111-3302
Country : US
Telephone Number : 801-325-9501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 07/08/2007

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