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General NPI Number Information
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NPI Number | 1861904153
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Entity Type | Individual
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Provider Name | EMILY SUMMERS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 5005 W OVERLAND RD
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City | BOISE
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State | ID
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Zip | 83705-2633
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Country | US
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Telephone | 208-389-1448
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Fax |
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Provider Business Mailing Address
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Address Line | 4173 N BEAHAM PL
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City | MERIDIAN
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State | ID
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Zip | 83646-3730
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Country | US
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Telephone | 406-239-2039
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P7871
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License Number State | ID
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