Individual
MADISON HILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
610 W HAYS ST, BOISE, ID 83702-5511
(208) 381-7092
Mailing address
5735 S ORCHID WAY, BOISE, ID 83716-7019
(304) 914-2006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P9581
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P9581
PHARMACIST LICENSE
ID
Enumeration date
08/30/2021
Last updated
08/30/2021
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