Phu M Doan, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

7161871 Issued in ID

Practice address

1625 S Meridian Rd
Meridian, ID 83642-9355

Phone

(208) 319-0600

Fax

(208) 319-0606

NPI assigned

Aug 26, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Walgreen Co

  • Pharmacy
  • Meridian, ID
  • NPI 1154503837
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1619700598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12340 W PALM DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135822",
            "telephone_number": "208-761-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 S MERIDIAN RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429355",
            "telephone_number": "208-319-0600",
            "fax_number": "208-319-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN",
        "first_name": "PHU",
        "middle_name": "M",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "7161871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Dixon, DDS
• Sara Dixon
• Sabrina Dlouhy, PA-C
• DM Management PC
• Julie Doan, DPT
• Doctor'S Hospice of Idaho LLC
• Doctors House Calls, LLC
• Carson Dodd, DPT
• Fred David Dodge, LCSW
• Sarah N Dodge, PT

• Pharmacist in Meridian, ID
• Providers in Meridian, ID by specialty
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.