Healthcare Provider Details

I. General information

NPI: 1184532459
Provider Name (Legal Business Name): MUZDALIFA HAMAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 1ST ST S
NAMPA ID
83651-3703
US

IV. Provider business mailing address

207 1ST ST S
NAMPA ID
83651-3703
US

V. Phone/Fax

Practice location:
  • Phone: 208-721-5325
  • Fax:
Mailing address:
  • Phone: 208-721-5325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2771573
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: