Matthew Araki
Individual provider Active NPI Pharmacist · Boise, ID
NPI 1760093124 · NPPES record last updated Aug 11, 2020
Key facts
- NPI
- 1760093124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- P8946 (ID)
- Practice address
- 1515 W State St
Boise, ID 83702-4039 - Phone
- (208) 345-7684
- NPI assigned
- Aug 11, 2020
- 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 |
|---|---|---|---|
| P8946 | ID | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P8946 | ID | Yes |
Addresses
Primary practice location
1515 W State St
Boise, ID 83702-4039
Mailing address
2906 Greenvale PL
Nampa, ID 83686-8257
Phone (208) 615-6928
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2020. 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.