Individual
EMALIE BUMGARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
583 COMMERCE DRIVE, SMELTERVILLE, ID 83868-0000
(208) 783-2739
Mailing address
PO BOX 1063, PINEHURST, ID 83850-1063
(208) 512-5693
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
I58719
ID
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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