NPI age
19 years
Enumerated 2006-09-04
Across 1739 active pharmacist providers in Idaho.
16 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 524CP | IDAHO STATE LIC. # |
| 01 (ID) | 13-00223 | NABP |
Multi-provider organization. 16 individual providers on file at this primary address.
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