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NPI Code Detail

MEDICARE: MRS. FRANCINE LORRAINE KIMBALL RPH

MEDICARE: MRS. FRANCINE LORRAINE KIMBALL RPH
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistP5005ID

General Provider Information

NPI Number : 1780973370
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FRANCINE LORRAINE KIMBALL RPH
Provider Business Mailing Address
First Line : 5425 W CHINDEN BLVD
Second Line :
City : GARDEN CITY
State : ID
Zip : 83714-1468
Country : US
Telephone Number : 208-323-7036
Fax Number : 208-323-7033
Provider Business Practice Location Address
First Line : 5425 W CHINDEN BLVD
Second Line :
City : GARDEN CITY
State : ID
Zip : 83714-1468
Country : US
Telephone Number : 208-323-7036
Fax Number : 208-323-7033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2011
Last Update Date : 04/04/2011

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