Holly J McGrath
Individual provider Active NPI Pharmacist · Fort Hall, ID
NPI 1346259355 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1346259355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 3580 (MT)
- Practice address
- Mission Rd
Box 717
Fort Hall, ID 83203 - Phone
- (208) 238-5408
- NPI assigned
- Aug 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 3580 | MT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3580 | MT | Yes |
Addresses
Primary practice location
Mission Rd
Box 717
Fort Hall, ID 83203
Mailing address
PO Box 4314
Pocatello, ID 83205-4314
Phone (208) 235-2336
Other providers in Fort Hall, 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.