Individual
PHILIP ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
524 TYHEE AVE, AMERICAN FALLS, ID 83211-1224
(208) 226-2411
Mailing address
524 TYHEE AVE, AMERICAN FALLS, ID 83211-1224
(208) 226-2411
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7578
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0347100001
—
ID
Enumeration date
07/19/2016
Last updated
12/09/2025
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