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Individual

DR. TROY COULSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 470-7979
(888) 626-5817
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 470-7979
(888) 626-5817

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
9763995-1701
UT
183500000X
Pharmacist
Primary
P7519
ID
183500000X
Pharmacist
PHA-PHA-LIC-62955
MT
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
P7519
ID
1835P1200X
Pharmacotherapy Pharmacist
P7519
ID

Other

Enumeration date
06/22/2016
Last updated
04/23/2024
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