Individual
MONA FOUAD KHASHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 831-2490
Mailing address
11267 W MORELA DR, BOISE, ID 83709-7096
(770) 597-3730
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
P7361
ID
183500000X
Pharmacist
Primary
RPH027989
GA
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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