Individual
ROBERT ALAN MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3020 6TH ST # A, LEWISTON, ID 83501-4653
(406) 396-2361
Mailing address
3020 6TH ST # A, LEWISTON, ID 83501-4653
(406) 396-2361
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7342
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS39698
CONTROLLED SUBSTANCE IDENTIFICATION NUMBER
ID
01
—
P7342
PHARMACIST LICENSE
ID
Enumeration date
07/31/2015
Last updated
07/31/2015
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