Donald W Goetsch, PHARMACIST
Individual provider Active NPI Pharmacist · Orofino, ID
NPI 1215065487 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1215065487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- P3809 (ID)
- Practice address
- 1105 Michigan Ave
Orofino, ID 83544-2625 - Phone
- (208) 476-5727
- Fax
- (208) 476-4045
- NPI assigned
- Mar 1, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P3809 | ID | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P3809 | ID | Yes |
Addresses
Primary practice location
1105 Michigan Ave
Orofino, ID 83544-2625
Mailing address
PO Box 2625
1105 Michigan Ave
Orofino, ID 83544-2625
Phone (208) 476-3569
Other providers in Orofino, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.