Active NPI
Valentina Douangdara, PHARMD
- Pharmacist
- Salt Lake City, UT
National Provider Identifier
1750031761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8789362-1701
- Practice address
- 145 E 1300 S Ste 103
Salt Lake City, UT 84115-6118 - Phone
- (385) 212-2934
- NPI assigned
- Mar 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 8789362-1701 | UT | Primary |
Addresses
Primary practice location
145 E 1300 S Ste 103
Salt Lake City, UT 84115-6118
Mailing address
145 E 1300 S Ste 103
Salt Lake City, UT 84115-6118
Other practice location 1
3540 S 4000 W
West Valley City, UT 84120-3260
Phone (801) 969-8261
Other practice location 2
4401 Harrison Blvd
Ogden, UT 84403-3195
Phone (801) 387-2800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8789362-1701 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genoa Healthcare LLC | Past | Accepting new patients | |
| Genoa Healthcare LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Genoa Healthcare
- Long Term Care Pharmacy
- South Salt Lake, UT
- NPI 1588942502
-
- Long Term Care Pharmacy
- Brockton, MA
- NPI 1992521512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648080000000",
"number": "1750031761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 E 1300 S STE 103",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841156118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 E 1300 S STE 103",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841156118",
"telephone_number": "385-212-2934"
}
],
"practiceLocations": [
{
"address_1": "3540 S 4000 W",
"address_purpose": "LOCATION",
"city": "West Valley City",
"state": "UT",
"postal_code": "841203260",
"country_code": "US",
"telephone_number": "801-969-8261",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4401 Harrison Blvd",
"address_purpose": "LOCATION",
"city": "Ogden",
"state": "UT",
"postal_code": "844033195",
"country_code": "US",
"telephone_number": "801-387-2800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOUANGDARA",
"first_name": "VALENTINA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-24",
"last_updated": "2022-03-24",
"certification_date": "2022-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "8789362-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.