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Individual

LINDA MAINVIL-FISCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
805 W FRANKLIN ST, BOISE, ID 83702
(208) 493-2396
(208) 381-6340
Mailing address
PO BOX 1990, BOISE, ID 83701-1990
(208) 493-2396

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5348
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P5348
IDAHO STATE BOARD OF PHARMACY
ID
Enumeration date
09/01/2015
Last updated
05/22/2018
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