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General NPI Number Information
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NPI Number | 1912483785
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Entity Type | Individual
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Provider Name | JEFF BUFFINGTON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 3475 E 17TH ST
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City | AMMON
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State | ID
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Zip | 83406-6781
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Country | US
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Telephone | 208-608-2976
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Fax |
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Provider Business Mailing Address
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Address Line | 5177 CANTERBURY ST
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City | CHUBBUCK
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State | ID
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Zip | 83202-5065
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Country | US
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Telephone | 208-608-2976
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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 | P8064
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License Number State | ID
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