Individual
BILLY GERALD JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2102 NEZ PERCE DR, LEWISTON, ID 83501-4116
(208) 743-4434
(208) 743-9422
Mailing address
2102 NEZ PERCE DR, LEWISTON, ID 83501-4116
(208) 743-4434
(208) 743-9422
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
1225043342
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538562137
—
ID
Enumeration date
09/12/2018
Last updated
09/12/2018
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