Healthcare Provider Details

I. General information

NPI: 1417879990
Provider Name (Legal Business Name): MU CONCEPTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 SHOUP AVE STE 224
IDAHO FALLS ID
83402-3482
US

IV. Provider business mailing address

545 SHOUP AVE STE 224
IDAHO FALLS ID
83402-3482
US

V. Phone/Fax

Practice location:
  • Phone: 208-528-3939
  • Fax: 208-216-0230
Mailing address:
  • Phone: 208-528-3939
  • Fax: 208-216-0230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ZEBULON GRAHAM
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 208-528-3939