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General NPI Number Information
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NPI Number | 1174451371
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Entity Type | Individual
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Provider Name | ANDREW PEARCE MULL PHARMD, RPH
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Gender | Male
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Dates
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Enumeration Date | 05/11/2026
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Last Update Date | 05/11/2026
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Provider Practice Location Address
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Address Line | 1650 W STATE ST
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City | BOISE
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State | ID
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Zip | 83702-4040
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Country | US
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Telephone | 208-342-5651
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Fax |
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Provider Business Mailing Address
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Address Line | 521 E 41ST ST
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City | GARDEN CITY
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State | ID
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Zip | 83714-6535
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Country | US
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Telephone | 928-925-2503
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 8671275
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License Number State | ID
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