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General NPI Number Information
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NPI Number | 1952077919
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Entity Type | Individual
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Provider Name | SETH GOLDEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 1001 N 4TH ST
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City | COEUR D ALENE
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State | ID
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Zip | 83814-3113
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Country | US
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Telephone | 208-667-3860
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Fax |
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Provider Business Mailing Address
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Address Line | 2054 E GRAND TOUR DR
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City | HAYDEN
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State | ID
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Zip | 83835-7773
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Country | US
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Telephone |
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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 | 6874
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P9551
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License Number State | ID
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