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Individual

ROBERT W GEDDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 513-3470
Mailing address
4996 N BOTTICELLI AVE, MERIDIAN, ID 83646-6740

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6687
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P6687
IDAHO BOARD OF PHARMACY
Enumeration date
09/14/2012
Last updated
11/20/2019
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