Idaho State University

NPI #1417673351 in Meridian, Idaho

Provider Information

NPI Number: 1417673351
Entity Type: Organization
Organization Name: Idaho State University
Primary Specialty: Pharmacist
Enumeration Date: Oct 12, 2022
Last Updated: Oct 12, 2022

Practice Location

Address: 1311 E CENTRAL DR
City: Meridian
State: Idaho
ZIP Code: 83642-7991
Phone: (208) 373-1734

Authorized Official

Name: CYNTHIA LEE ROCK
Title: CLINICS DIRECTOR OF OPERATIONS
Phone: (208) 373-1743

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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