NPI age
14 years
Enumerated 2011-06-15
Across 1739 active pharmacist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | P5553 | IBOP PHARMACIST REGISTRATION |
| 01 (ID) | CS8805 | IBOP PHARMACIST CONTROLLED SUBSTANCE REGISTRATION |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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