Provider Demographics
NPI:1982694964
Name:SHANE-MCWHORTER, LAURA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:SHANE-MCWHORTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S 2000 E
Mailing Address - Street 2:ROOM 260 UNIVERSITY OF UTAH COLLEGE OF PHARMACY
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84112-5820
Mailing Address - Country:US
Mailing Address - Phone:801-585-9564
Mailing Address - Fax:
Practice Address - Street 1:461 S 400 E
Practice Address - Street 2:CENTRAL CITY CHC
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-3302
Practice Address - Country:US
Practice Address - Phone:801-325-9501
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT149291-17011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy