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General NPI Number Information
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NPI Number | 1659024594
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Entity Type | Individual
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Provider Name | ASHLYN COOPER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 100 HOSPITAL DR
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City | KETCHUM
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State | ID
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Zip | 83340
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Country | US
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Telephone | 87-278-3002
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Fax |
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Provider Business Mailing Address
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Address Line | 420 PINE VIEW LN
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City | BELLEVUE
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State | ID
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Zip | 83313-5261
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Country | US
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Telephone | 209-423-4848
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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 | P9832
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License Number State | ID
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