Provider Demographics
NPI:1619149499
Name:MCDOWELL, ERIC RENNER (PHARM D)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:RENNER
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1152 W 2240 S STE E
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-7245
Mailing Address - Country:US
Mailing Address - Phone:801-485-3344
Mailing Address - Fax:801-485-1982
Practice Address - Street 1:1152 W 2240 S STE E
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-7245
Practice Address - Country:US
Practice Address - Phone:801-485-3344
Practice Address - Fax:801-485-1982
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4550841-1701183500000X
UT4550841-8911183500000X
IDP5599183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist