Mackenzie Anderson, PHARMD
Individual provider Active NPI Pharmacist · Draper, UT
NPI 1245945443 · NPPES record last updated Jan 23, 2023
Key facts
- NPI
- 1245945443
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 7792607-8911 (UT)
- Practice address
- 176 E 13800 S
Draper, UT 84020-9548 - Phone
- (801) 307-1003
- NPI assigned
- Jan 23, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7792607-8911 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
176 E 13800 S
Draper, UT 84020
Phone (801) 307-1003
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7792607-8911 | UT | Yes |
Addresses
Primary practice location
176 E 13800 S
Draper, UT 84020-9548
Mailing address
236 W Amanda Lynn LN
Midvale, UT 84047-3571
Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.