Individual
R PATRICK FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
HIGHWAY 93 SOUTH, CHALLIS, ID 83226-0070
(208) 879-4600
Mailing address
PO BOX 70, CHALLIS, ID 83226-0070
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P4475
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P4475
STATE PHARMACIST LISCENCE
ID
Enumeration date
12/06/2006
Last updated
07/08/2007
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