Individual
WILLIAM PIRATE MADSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3475 E 17TH ST, AMMON, ID 83406-6781
(208) 227-5083
(208) 227-5087
Mailing address
3475 E 17TH ST, AMMON, ID 83406-6781
(208) 227-5083
(208) 227-5087
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4168
ID
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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