NPI 1013306968

Jason Ebrahimpour

Practitioner Pharmacist Caldwell, ID

Practice location

Address: 425 N 10th Ave, Caldwell, ID 83605-3402
Phone: (208) 454-1111

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence P6484 (ID)

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Registry record

NPI: 1013306968
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Jan 2015
Record last updated: 15 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.