Individual
EMMA LEIGH WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 SHOUP ST, SALMON, ID 83467-4300
(208) 756-1940
Mailing address
1200 SHOUP ST, SALMON, ID 83467-4300
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8361
ID
3336C0003X
Community/Retail Pharmacy
PHA-PHA-LIC-47255
MT
Other
Enumeration date
02/27/2018
Last updated
01/15/2021
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