Individual
CHARLES PARKER WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4657 S EAGLE RD, MERIDIAN, ID 83642-7077
(208) 272-9730
Mailing address
2728 E BERNICE DR, MERIDIAN, ID 83646-8060
(208) 890-6613
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P10754
ID
Other
Enumeration date
06/27/2023
Last updated
06/24/2024
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