Healthcare Provider Details

I. General information

NPI: 1174435747
Provider Name (Legal Business Name): HAYLEE BINGHAM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 KOOTENAI HEALTH WAY
COEUR D ALENE ID
83814-6051
US

IV. Provider business mailing address

415 W DODGE LOOP APT 303
COEUR D ALENE ID
83815-1026
US

V. Phone/Fax

Practice location:
  • Phone: 208-625-4000
  • Fax:
Mailing address:
  • Phone: 208-371-2268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2481812
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: