MEDICARE: DR. MARK A POPWELL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	16246	AL
2	183500000X	Pharmacist	P6772	ID

General Provider Information

NPI Number	:	1568746261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK A POPWELL PHARMD

Provider Business Mailing Address
First Line	:	1248 E 17TH ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-6126
Country	:	US
Telephone Number	:	208-497-0156
Fax Number	:	208-497-0068

Provider Business Practice Location Address
First Line	:	1248 E 17TH ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-6126
Country	:	US
Telephone Number	:	208-497-0156
Fax Number	:	208-497-0156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	07/09/2025

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Directions to “ DR. MARK A POPWELL PHARMD” Practice Location

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