Venetta Jean Christopherson, PHARMD, CGP

Individual provider Active NPI Geriatric Pharmacist · Pocatello, ID

NPI 1164585857 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1164585857
Entity type
Individual (NPI type 1)
Primary specialty
Geriatric Pharmacist 1835G0303X
License
P5129 (ID)
Practice address
436 E Bonneville
Pocatello, ID 83201
Phone
(208) 233-3466
Fax
(208) 234-9686
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
P5129IDMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Living Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Pharmacist 1835G0303X P5129 ID Yes

Addresses

Primary practice location

436 E Bonneville
Pocatello, ID 83201

Mailing address

5480 Country Club Dr
Pocatello, ID 83204-4681
Phone (208) 233-1464

Other providers in Pocatello, ID

All providers in Pocatello, ID · Geriatric Pharmacist in Idaho

Sources for this page

Verify at the official NPI Registry.