Individual
MELODIE GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2132 W PULLMAN RD, MOSCOW, ID 83843-4011
(208) 997-5082
(208) 207-2917
Mailing address
1143 BEAR CREEK RD, PRINCETON, ID 83857-9753
(208) 874-2176
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E17480
ID
3336C0003X
Community/Retail Pharmacy
Primary
P7306
ID
Other
Enumeration date
04/15/2015
Last updated
04/22/2022
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