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NPI Code Detail

MEDICARE: SHELBY WHITE PHARMD

MEDICARE: SHELBY WHITE PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1300XPsychiatric PharmacistPHA-PHA-LIC-37907MT

General Provider Information

NPI Number : 1689024663
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY WHITE PHARMD
Provider Business Mailing Address
First Line : 500 W FORT ST
Second Line : 119
City : BOISE
State : ID
Zip : 83702-4501
Country : US
Telephone Number : 406-334-0540
Fax Number :
Provider Business Practice Location Address
First Line : 500 W FORT ST
Second Line : 119
City : BOISE
State : ID
Zip : 83702-4501
Country : US
Telephone Number : 406-334-0540
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2016
Last Update Date : 03/13/2026

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Directions to “ SHELBY WHITE PHARMD” Practice Location

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