Individual
GARY MONDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1901 S 2500 E, AMMON, ID 83406-5710
(208) 524-1616
(208) 528-6563
Mailing address
540 BOB-O-LINK DRIVE, IDAHO FALLS, ID 83401-3854
(208) 529-5395
(208) 528-6563
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
P4082
ID
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-0006399
OR
Other
Enumeration date
08/17/2011
Last updated
08/17/2011
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