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Individual

DR. WADE H FLOWERS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D., BCPS, CGP

Contact information

Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 782-3770
(208) 782-3709
Mailing address
13103 W RESERVATION RD, POCATELLO, ID 83202-5129
(208) 238-1281
(208) 782-3709

Taxonomy

Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
P4656
ID
1835P1200X
Pharmacotherapy Pharmacist
Primary
P4656
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1381
CGP
ID
01
3 08 010444
BCPS
ID
Enumeration date
06/16/2005
Last updated
04/01/2010
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