Provider Demographics
NPI:1841730454
Name:MCDONALD, SHANA (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:SHANA
Other - Middle Name:
Other - Last Name:TOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:5100 PRAIRIE PKWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-8155
Mailing Address - Country:US
Mailing Address - Phone:319-222-2906
Mailing Address - Fax:319-222-2996
Practice Address - Street 1:5100 PRAIRIE PKWY
Practice Address - Street 2:SUITE 106
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-8155
Practice Address - Country:US
Practice Address - Phone:319-222-2906
Practice Address - Fax:319-222-2996
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21564183500000X
OH03331352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist