Individual
ONOME BENJAMIN JONAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
2745 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647-3185
(208) 587-0861
Mailing address
2745 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647-3185
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6231
ID
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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