NPI age
11 years
Enumerated 2014-07-03
Across 1739 active pharmacist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | P7059 | PHARMACIST LICENSE |
| 01 (ID) | CS36009 | PHARMACIST CONTROLLED SUBSTANCE REGISTRATION |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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