NPI age
16 years
Enumerated 2010-01-12
Across 1739 active pharmacist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | P5750 | PHARMACIST LICENSE |
| 01 (WA) | PH00069808 | PHARMACIST LICENSE |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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