Healthcare Provider Details

I. General information

NPI: 1730356304
Provider Name (Legal Business Name): MARC MURDOCK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11801 W EXECUTIVE DR
BOISE ID
83713-0803
US

IV. Provider business mailing address

11801 W EXECUTIVE DR
BOISE ID
83713-0803
US

V. Phone/Fax

Practice location:
  • Phone: 208-706-6245
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00064767
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7181509
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: