Richard Wayne Black
Pharmacist in Idaho Falls, ID. Individual provider (NPI-1).
NPI number1093545014
StatusActive
Last updated in NPPESAug 5, 2024
Details
- NPI
- 1093545014
- Entity type
- Individual (NPI-1)
- Name
- Richard Wayne Black
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 5, 2024
- Certification date
- Aug 5, 2024
- Last updated
- Aug 5, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 7161471 | ID | Yes |
Practice location
2325 Coronado StIdaho Falls, ID 83404-7407
Phone 208-557-2738
Mailing address
2325 Coronado StIdaho Falls, ID 83404-7407
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All 92 Pharmacist providers in Idaho Falls · All 3,646 providers in Idaho Falls
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