Douglas Grant Card, RPH
Individual provider Active NPI Pharmacist · Highland, UT
NPI 1255351102 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1255351102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 140359-1701 (UT)
- Practice address
- 5353 N 11000 N
Highland, UT 84003 - Phone
- (801) 756-8353
- Fax
- (801) 756-3525
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 140359-1701 | UT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 140359-1701 | UT | Yes |
Addresses
Primary practice location
5353 N 11000 N
Highland, UT 84003
Mailing address
121 N 800 E
American Fork, UT 84003-2015
Phone (801) 756-2250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870309253012 | Medicaid | UT |
Other providers in Highland, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.