NPI age
7 years
Enumerated 2019-03-07
Across 1739 active pharmacist providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | P8202 | IDAHO PHARMACIST LICENSE |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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