Individual
ROHAN SRIHARI RAGHURAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
Mailing address
2726 17TH ST, LEWISTON, ID 83501-6375
(334) 324-5104
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
P10113
ID
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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