Komoda, Neil Tetsuo
Komoda, Neil Tetsuo is an individual health care provider with primary practice located at 2425 Channing Way , Idaho Falls ID 83404-8059. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Komoda, Neil Tetsuo can be contacted via phone (208) 523-2277.Contact Information
Primary practice address
2425 Channing Way
Idaho Falls ID 83404-8059
Phone: (208) 523-2277
Fax: (208) 552-1246
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | P3674 | Idaho |
Profile Details
| NPI number | 1467517201 |
|---|---|
| LBN Legal business name | Komoda, Neil Tetsuo |
| Credentials | PHARMACIST |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467517201 | NPPES |
| Idaho | Other | 421CP | LICENSE |
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