Komoda, Shane Kazuo

Komoda, Shane Kazuo is an sole proprietor health care provider with primary practice located at 500 W Fort St , Boise ID 83702-4501. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Komoda, Shane Kazuo can be contacted via phone (208) 422-1000.

Contact Information

Primary practice address
500 W Fort St Boise ID 83702-4501
Phone: (208) 422-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X P5938 Idaho

Profile Details

NPI number 1497895353
LBN Legal business name Komoda, Shane Kazuo
Credentials PHARM.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 8th, 2007
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.

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