CASSIDY LOUISE DOMAGALLA NPI 1386222685

NPI Information

NPI: 1386222685
Provider Name: CASSIDY LOUISE DOMAGALLA
Classification: Pharmacist - 1835G0303X
Entity Type: Individual

Specialization: Geriatric

Address:
126 OAK ST
PEORIA, IL
ZIP 61602
Phone: (309) 690-7790
Get Directions

Cassidy Louise Domagalla is a geriatric pharmacist in Peoria, IL. The provider is a pharmacist who is certified in geriatric pharmacy practice is designated as a Certified Geriatric Pharmacist (CGP). To become certified, candidates are expected to be knowledgeable about principles of geriatric pharmacotherapy and the provision of pharmaceutical care to the elderly. Cassidy Louise Domagalla NPI is 1386222685. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

126 OAK ST
PEORIA, IL
ZIP 61602-639
Phone: (309) 690-7790
Fax: (866) 385-4948

The enumeration date for this NPI number is 3/30/2021 and was last updated on 3/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1835G0303X	Pharmacist	Geriatric	051.296273	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	051.296273	OTHER	ILLINOIS	STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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