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Individual

MR. RON STUMBO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
MOUNTAIN HOME AFB, MOUNTAIN HOME AFB, ID 83648
(208) 828-7480
Mailing address
626 W BEAR TRACK DR, MERIDIAN, ID 83642-8107
(208) 828-7485

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
10767
AL
183500000X
Pharmacist
Primary
5204
ID

Other

Enumeration date
09/07/2005
Last updated
07/08/2007
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