Individual
MARK SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1600 N MAIN ST, MERIDIAN, ID 83642-1709
(208) 888-7311
Mailing address
1600 N MAIN ST, MERIDIAN, ID 83642-1709
(208) 888-7311
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5818
ID
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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